Insurance companies are eager to deny your claim for long-term benefits even if you are seriously injured and unable to work. Donachie is a great example an insurance company denying a person who had a serious impairment. The best thing you can do is consult an attorney early in the process.
Donachie was employed at FleetBoston Financial. In 2001, he underwent surgery to replace his aortic valve. Unfortunately for Mr. Donachie, he suffered from an unanticipated side effect where he could feel and hear the compressions of the prosthetic valve with each beat of his heart. The sounds were even audible to other people in the same room. This caused him to be “psychologically crippled.” It also caused Donachie “a great deal of anxiety,” resulting in physical and mental exhaustion from lack of sleep, and rendering him unable to perform his current job.
In 2004, Liberty Mutual denied Donachie’s claim for benefits under his Long Term Disability plan. Donachie filed a claim for relief and the United States Court of Appeals, Second Circuit reversed Liberty Mutual’s finding that he was not disabled. The court reasoned that Liberty’s decision was arbitrary and capricious; also they ignored substantial evidence from Donachie’s treating physician.
http://law.justia.com/cases/federal/appellate-courts/ca2/12-2996/12-2996-2014-03-11.html