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Sometimes, an insurance company denies a claim from the insurance holder on account of wrong assessment of his claim. This may lead the insured to suffer:

1. Financial damages in the sense that he may fail to get the right treatment because of the lack of funds.

2. Lapse of time in the sense that the insured may lose reasonable time for the proper treatment, and his/her medical condition may become severer.

The only way out is to do the standard reversed for ignoring medical evidence and improper denial

Illustration

A person has been diagnosed with cancer, and the doctor decides to release them on “as tolerated” basis. This signifies that the said person may not be able to complete his working hours due to medical issues. Moving further, the insurance company denied his insurance claim due to either or both
of the following situations;

1. It overlooked the term “partial disability” and mentioned that the person was able to work 100%.

2. In a bid to back its statement, the company provides proof of him working on part-time basis elsewhere.

In such situations, the court may give priority to the medical history of the insured, before it considers any other pieces of evidence no matter how conclusive they are.

 

The Lawsuit: Ms. Marcin V Reliance Standard Life Insurance Company

The lawsuit we’re referring to was held in the district court of Columbia, United States. It was about the unreasonable consideration made by Reliance Standard Life Insurance Company of insured’s health.

According to the plaintiff, Ms. Jill Marcin, she was suffering from multiple health issues such as anemia, kidney cancer, and others. She was released by her doctors on “as tolerated” basis, which means, she couldn’t complete 40 working hours every week as normal employees do. This medical evidence amounts to “partial disability”.bfhd

Instead of considering her partial disability, the defendant – Reliance Standard Life Insurance Company – treated it as “total disability” which had an entirely different meaning (the person may not be able to work at all and is entitled to benefits).

Based on the wrong assumption, the company concluded that as Jill Marcin was working on a part-time basis, she could work 100%.
Therefore, her claim for long-term benefits was denied because she wasn’t disabled.

To support the decision, the defendant referred to two instances when the doctor had reviewed her medical condition as “feeling better”. Yes, there were a few instances when her doctor noted that she was “feeling better”, but her overall health was generally on the decline. Ms. Marcin’s absence from work increased with time, as her overall health was depleting.

 

What Court Considered

The district court ruled its decision in favor of the plaintiff and held the insurance company liable for payment of all the dues. Later, the U.S. Court of Appeals for the District of Columbia affirmed and given the same judgment.

RSL Insurance was unreasonable in determining that she was completely capable of doing 100% work. The medical history evidently showed that she hadn’t managed to complete a 40-hour week.dsvfdb

The decision made by RSL did not acknowledge the fact that her work showed she never worked full time. It was evident from the record that her work hours reduced sharply.

The RSL could not address the fact that Ms. Marcin’s health condition had gone from “mild” to “extreme”.

RSL relied on paid medical reviews. The unreliability of the reviews is based on the fact that the examination and the medical history were not linked.

One review was deemed unreliable because it wasn’t conclusive enough.…

When it comes to selecting an attorney at custody lawyer bowling green who will represent your family, you should do it after careful deliberation because it is a big commitment. Many factors will determine your selection of your attorney from their knowledge of the industry to the charges they charge and much more. Such factors will play a significant role in determining whether the attorney is suitable for your needs or not. This article articulates some general factors that should be looked at before hiring an attorney.

Tips For Hiring An Attorney

A Strong Track Record Of Integration

It is important to identify the legal experts that have experience in your field of interest. If you want a family lawyer, get an attorney that has specialized in that area because not all general attorneys can handle such cases. Also, the success of the matter will not be solely dependent on the knowledge of the law, but also the integration of the knowledge of the reviews, procedures and the people.

Personality

It may sound like a minor factor, but there is importance in settling in a lawyer that you like. Your lawyer should not only protect you, but they should help you to manage the anxiety that comes with the case you are dealing with. If you do not have a liking towards your lawyer, they will not perform that task effectively. It will also be difficult for you to trust someone that you do not like.

Alternative Billing Structures

When it comes to billing structures, you should be in agreement with your attorney so that you can work effectively and in harmony. Some attorneys offer alternative billing structures like flat rates or a percentage on what they charge per project. If you want to prevent surprise legal fees or hidden costs, you should opt for having a flat rate or a cost cap.

References

If it is your first time to look for an attorney, you can ask around from friends, family, and colleagues. Perhaps you do not know where to start from, but the people around you have dealt with some, and they can recommend the best ones for you. If you get them from credible sources online, you can call the writers of the reviews to ask them how they found the attorneys, their personalities, and other additional information that you may need to decide whether you will hire them or not. Ensure that you get an attorney who has had a personal experience with people you have asked.…

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A common misconception goes that people in the United States file many lawsuits. On the contrary, sometimes it seems like the best way out in resolving some things. Cases like personal injuries at work or home and other institutions due to negligence are common. The first thought when caught in such situations is to shrug it off and go back to the normal way of life. The following are a few things you should consider when hiring atlanta personal injury lawyer;

Why should I look for a personal injury attorney in Atlanta?

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Within your area in Atlanta, you should look for the best personal injury lawyer to take up your case. This will save you not only time but travel expenses. Consider one who specializes in personal injury cases. Conduct your research widely and ensure that they are aware of all state and local laws before you put anything in writing.

Can I get referrals for attorneys?

Yes, it is okay to request for referrals of attorneys within your area. You can inquire from friends and family who have dealt with personal injury attorneys in Atlanta. Ask them about their track record. You can also get such referrals from other lawyers you have. They can give you credible peer referrals. Once you settle on a lawyer you wish to hire, you can check on their reputation with the state or local bar association.

Do they fit into my budget?

Finding the right attorney means finding one whose services you can afford. You should inquire about this from your first meeting with the lawyer. This will help you manage your budget for the case. It is wise not to pay any fees upfront. Maintain your focus on the case and getting all the necessary documents to support your claim. Ask questions where you are not sure. Append signatures to documents only when sure.

What questions can I ask the Attorney?

If you intend to hire a personal injury attorney there are important questions that you should ask them to really decide if they are best suited for the job:-

  • Are they the ones who will deal with the case to the end?
  • How many years of professional experience do they have?
  • What fee will be charged for the case?
  • Does the attorney only specialize in personal injury cases?
  • If there are other lawyers who will be party to the case, is it possible to talk with them as well?
  • What duration is the case likely to take?
  • How much money will I get from the claim settlement?

Once satisfied with answers from the attorney, go ahead and request for an agreement in writing. Sign only when sure you are ready to take up the attorney.

 

What Will Follow Signing the Agreement?

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No need to worry on what follows next. From here on, your personal injury attorney is your best advisor. He or she will file the claim on your behalf as well as review any related paperwork. The favorable settlement of your claim is now in the hands of your attorney; he or she is the professional who will fight for your compensation.

 …

Most of the times, the choice of a lawyer is the make-break of a case. Lawyers have the technical knowledge of swaying your case this way and that way until justice is done to you. So, next time you have a case to answer in a court of law, think carefully of who will defend you.

Finding the best law firms for your case online

2There are several personal injury law firms that have been licensed to operate in the Fresno, California area. You just need to look for these firms online and choose fresno personal injury lawyer the one that you like. Whether you were involved in auto collisions, spinal injuries, brain injuries, or medical malpractice, you can have justice delivered to you by a lawyer of your choice. It is always important to consider your specific case carefully before you choose a lawyer to defend your interests in a court of law. For instance, a lawyer may be good in the litigation of a premises liability or wrongful death case and not other cases. He or she may also be good in both.

Connect with your chosen lawyers on social media

Social media networks have revolutionized the way people communicate to one another and to other businesses. Let us remember that the most important thing to look for when choosing a lawyer is efficient communication. If you visit a Facebook page or a Twitter handle belonging to a certain law firm, you will know how a certain law firm communicates with its clients. You will also get a lot of information that you couldn’t have got elsewhere. For example, there are some posts relating to tips and tricks for getting the compensation you deserve for personal injury or family and divorce cases. If you are looking for divorce and family lawyer in Fresno, California for instance, just look for an official page of a law firm and you will get all the advice that you need even before you decide on choosing a lawyer for your case.

What information can you get a social media pages a lawyer?

3 People are on social media networks to interact and mingle with other people from all parts of the world. Social media network pages belonging lawyers are thus platforms for interactions with other people on the social media. If you visit a Facebook page or a Twitter handle belonging to a personal injury lawyer, observe with special attention the interaction between the lawyer(s) in question with other people on the network. From these interactions, you will be able to know the lawyer(s) in black and white and determine whether they are suitable for your case. For instance, the way they respond to questions raised by various people will give you an idea of how they will respond to your questions. Their posts will also give you an idea of their expertise and knowledge. You will also read reviews and check the rating given to the law firm in question by previous clients. Just visit the Facebook page of Tomassian Pimentel & Shapazian, and you will know what I mean.…