Local Law Firm`s Fight for Florida Woman`s Disability Insurance Benefits Featured on Good Morning America
Released on: May 2, 2008, 3:26 pm
Press Release Author: Cheryl Flowers
Industry: Law
Press Release Summary: Woman with Stage IV Breast cancer was denied disability insurance benefits by Cigna. A local law firm was successful in overturning this denial. Good Morning America covered the story on April 25, 2008.
Press Release Body: Life became very difficult when Susan Kristoff, a native Floridian, became diagnosed with Stage IV, Metastatic Breast Cancer. Too ill to work, Ms. Kristoff had no choice but to file a claim for disability insurance benefits. Despite the obvious debilitating mental and physical effects of her illness, CIGNA overwhelmed Ms. Kristoff with burdensome requests for information and "proof" that her medical condition caused her to be unable to perform her job duties as an outside sales person. After more than 5 months of Ms. Kristoff responding to CIGNA‟s onslaught, the company denied her claim for income benefits. Realizing that she needed the help of a qualified attorney in order to obtain the insurance benefits to which she was entitled, Ms. Kristoff hired Flowers Paulino-Grisham, PL, a renowned disability insurance law firm in Florida.
Flowers Paulino-Grisham, PL has successfully handled hundreds of disability insurance claims. As advocates for the insured, their attorneys are very familiar with the delay and offensive tactics used by insurance companies to delay and deny benefit claims. Thus, they were all too familiar with Ms. Kristoff's story when she called them for help. Upon being hired, Flowers Paulino-Grisham, PL submitted an extensive appeal to CIGNA, outlining the unreasonableness of their denial. As Ms. Kristoff was still unable to return to work, Attorney Paulino-Grisham also submitted Ms. Kristoff's claim for long-term disability benefits. The Firm was successful in procuring Ms. Kristoff's short-term disability benefits based upon that appeal. The local media got wind of Ms. Kristoff's compelling story. Personal interviews of Ms. Kristoff and Attorney Paulino-Grisham aired on a local television news program and subsequently in a local newspaper.
Despite clear proof establishing Ms. Kristoff's right to continued disability benefits, CIGNA delayed a decision until finally advising her that it was now denying her long-term disability claim because it had determined that she had a pre-existing condition under the terms of the policy.
This "preexisting condition" that CIGNA alleged was previously diagnosed cancer that had already been treated and cured. Ms. Kristoff had not had any recurrences and was considered cancer-free at the time she signed up for her disability insurance policy. This was explicitly documented by her physicians, but that made no difference to CIGNA. Flowers Paulino-Grisham submitted another extensive appeal that outlined that Cigna's interpretation of the Policy was contractually and legally unreasonable.
Subsequently, Good Morning America contacted Attorney Paulino-Grisham, interested in helping its viewers better understand and deal with insurance claims. Attorney Paulino-Grisham advised them of her experiences with insurance companies, the tactics normally employed by insurance carriers, and later specifically used Ms. Kristoff's case as an illustration. Outraged, the executives decided that the American public needed to know what insurance companies were getting away with. As a result, Ms. Kristoff and her primary attorney, Alicia Paulino-Grisham, were given an opportunity to tell their story on the show. During the interview, Attorney Paulino-Grisham explained that Ms. Kristoff was one of hundreds of claimant's unreasonably denied benefits.
Prior to the airing of the show CIGNA finally admitted that Ms. Kristoff's condition was not pre-existing and that it was disabling her from returning to work. Flowers Paulino-Grisham succeeded in obtaining for Ms. Kristoff the benefits she was rightfully owed under her insurance plan.
Things may have ended up differently if Ms. Kristoff had never sought legal counsel. This is because many insurance companies use a process known as "slow-walking,‟ where they delay the claim and frustrate their insured's so much, people just give up. Insurance companies know the willpower is not as strong when a person is trying to handle the many aspects of a disability by themselves. Additionally, an individual may not understand all of the legalese associated with their claim for insurance benefits, many times including the significance that federal law, including The Employee Retirement Income Security Act of 1974 ("ERISA"), has on their benefit claim.
"Disability insurance policies are often drafted with ambiguous contractual terms--thus providing insurance companies with ample ammunition to deny and delay the payment of a disability insurance claim," explains Alicia Paulino-Grisham. Many people simply do not understand their rights under their policy and the law.
Attorney Alicia Paulino-Grisham is a partner with the Law Firm of Flowers Paulino-Grisham, PL which focuses on individual and group Disability Insurance Claims at all stages of the claims process. For more information please visit: www.Flowerspaulino-Grisham.com.
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