Legal Question in Insurance Law in Massachusetts

Disability insurance discontinued w/o med. exam

I was involved in an MVA at the end of Nov. 02. I was hit from behind on highway by a car doing 40- 50 mph.Obviously I was injured by the crash. Severe neck pain and very bad headaches. CT SCAN WAS O.K. X-RAYS O.K. I was put into P.T for a while with little improvement. Dr. removed me from P.T and prescribed home traction 3 times per day @ 1/2 hr. each. I had purchased disability insurance through my employer. I worked as a service advisor for a dealership when injured (I was driving to work). The disability ins. co. sent me a letter stating coverage would not continue. They had paid me for 8 weeks (policy has 26 week limit). Ins co stated a nurse had reviewed records and determined I should have recovered within 1 week. MRI shows disc protrusion in neck. Dr notes still state total disability as I can not sit in front of computer for more than 1-2 hours without pain. Is the insurance co justified in doing this ?


Asked on 3/19/03, 2:52 pm

2 Answers from Attorneys

Patricia Joyce Law Office of Patricia M. Joyce

Re: Disability insurance discontinued w/o med. exam

You have the right to appeal the decision of the insurance company.

Although you can do this by asking your doctor to write a letter stating

his/her opinion that you cannot work, it is best if you are represented by

an attorney so that the insurance company knows that you have been adequately

advised of your rights.

If the insurance company still disagrees, you can appeal the decision (depending

on the policy) either through the courts or arbitration or mediation. Insurance companies

start to pay attention when it is alleged that they are acting in bad faith because there

are serious consequences that can arise when it is shown that they are trying to avoid abiding

by their policies.

I do hope you are feeling better soon. Feel free to contact me if I can be of further assistance.

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Answered on 3/19/03, 4:21 pm
Benjamin Glass Law Offices Benjamin W. Glass & Associates

Re: Disability insurance discontinued w/o med. exam

I have prepared a free 22 page report which outlines the many mistakes claimants make in applying for disability insurance benefits. Send me an email and I will get it out to you .. You will probably find it helpful

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Answered on 4/13/03, 2:05 pm


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