Life Insurance Claim Appeal Wins $250,000 Without Entering A Courtroom
Years before the ice bucket challenge took Facebook walls by storm, twenty-five year old Joe Pipitone had no idea how to tell his then fifty-five year old mother she was losing a battle with a disease both he and the rest of the world didn’t know much about.
The Disease
Amyotrophic Lateral Schlerosis, Lou Gehrig’s disease, is a vicious killer. According to the ALS Association, 5,600 Americans are diagnosed with the disease each year and eighty percent of that number will perish within five years of diagnosis. As later showcased in the Hollywood hit The Theory of Everything, it is a disease that erodes the nervous system, leaving the mind intact as the body slowly loses control of its functions. Those who suffer from the disease become increasingly dependent on their caretakers as their muscles lose control, shutting down one by one, until even the simplest function, breathing, is not possible.
Joe The Caretaker
A promising student, Joe had just graduated with two masters degrees, a steady girlfriend, even a child on the way. However, this tornado of a disease brought Joe’s world to a halt. Joe, whose father had recently passed, needed to move home to rural North Carolina to take care of his mother, not because he was a medically trained professional or even a well-to-do son who could afford time off, but because, with her refusal to go into a home and the disease being as strong as it was, simply put, someone had to do it. Joe’s job search had to take a time out. His mother came first.
The disease had other plans.
Tough Times
The disease moved much swifter than anyone could have foreseen, and within two years, Joe’s mother had passed. Joe was heartbroken – and, to make tough times worse, even further in debt. The tough job market when he left had only declined. He had sent out over 128 resumes in North Carolina as well as in two surrounding states, to no avail. He turned to his mother’s life insurance policy hoping for some relief. But to his surprise, there was none to be found. Without a word from the insurer, Pipitone received a letter denying the claim and a check refunding the money his mother had put into the policy.
Pre-Existing Conditions
His mother’s insurance company denied Joe’s claim because they said she suffered from a stroke history that she didn’t disclose prior to coverage. Joe, whose mother never had a stroke, was confused, but the insurance company was insistent: her Transient Ischemic Attacks or TIA’s were, as the insurance company put it, mini-strokes. Yet since the form didn’t ask one question about TIAs and his mother had never had a stroke, she answered honestly, saying no, she had no history of strokes. The claim was denied. The insurance company refused to pay Joe the balance of her policy.
“What Am I Going To Do Now?”
Alone, parentless, unsure how to even define the TIAs in order to respond their nightmarish legalese, all seemed lost to Joe.
“I couldn’t stop thinking, ‘What am I going to do now? How am I going to survive?” Pipitone said.
Then came the moment that would change his now 27-year-old life.
Turning To The Center for Life Insurance Disputes
After a lengthy google search, Joe contacted the Center for Life Insurance Disputes. Joe explained the situation, the TIAs, and despite the insurance company’s mismanagement and avoidance of the issue – “Losing papers! It was criminal!” – he hoped for the best.
A member of The Center, Steve Burgess, took action. The Center For Life Insurance Disputes helps people just like Joe who have strong legal cases against big insurance, but can’t afford the burden of cost of a lengthy trial.
Burgess was sure he could help Joe.
It came down to defining the truth: how could they legally define these mysterious TIAs?
Defining The TIAs
The Center contacted the American Heart Association for clarity on what a TIA truly was – were these in fact strokes as the insurance company claimed or were they what Joe’s mother had assumed – something else entirely? The American Heart Association sent him a statement, “a stroke is not a TIA, and a TIA is not a stroke – the two events are distinctly separate.”
The Center contacted the insurance company, who then evaded both Burgess and Pipitone. The insurance company would refuse to speak directly with either on the matter, leaving general messages at 3 AM to avoid talking directly with either. It reached a point where the insurance company barely sent correspondence about the claim. The Center took an alternative route and the insurer responded.
A Surprise In The Mail
Almost three years had gone by since his mother’s death. But in March 2011, Pipitone was shocked at what was in his mailbox: a check for $250,000.
Joe’s world changed overnight. “When the check came through, me being in the unemployed position and my fiancé barely making above the poverty level, we were able to move to Ohio where her entire family lives. I could get a job, a house, and we could literally get our lives on track,” Pipitone said.
Somewhere out there, one young college graduate used the truth to tackle his Goliath. And, while it can’t bring back his mother, it can both help him, as well as others.
To get help with your life insurance claim appeal contact The Center For Life Insurance Disputes directly at 888-428-4868.
