My client suffers from a couple of different debilitating medical conditions. He purchased an AFLAC policy at work, which was supposed to pay him when he was off work as a result of illness or injury. The maximum benefit was for 6 months, at which point AFLAC would not pay anymore for that particular medical problem until he had returned to work for a certain time. My client was off work for 6 months, and then went back to work. Shortly thereafter, before the “return to work period” had expired, he had to go back off work for another medical problem.
AFLAC refused to pay, claiming that this was the same medical problem that they had previously paid for and that my client had not been back at work long enough to qualify for additional benefits for that medical problem. The medical evidence shows that although the new medical condition was to the same area of the body, it was a different medical condition. Accordingly, my client would be entitled to recover up to another 6 months of disability insurance benefits.
On Monday, I filed a lawsuit against AFLAC for breach of contract. As with most of my insurance cases, if I win this lawsuit, the insurance company will be required to pay all of my fees and costs, and if I lose, I will work for free.