Case Studies - Orthopedic Surgeon

Disabled Orthopedic Surgeon Obtains Insurance Settlement of More Than $3 Million

Our client, an orthopedic surgeon, could no longer practice surgery due to numbness in his hands and fingers, among other infirmities caused by diabetes.

His insurance company denied his Total Disability Claim on the grounds he was still practicing medicine even though he was no longer performing surgery.

The insurance company argued that he was actually earning more money without the surgery part of his practice because of income he was deriving from diagnostics, physical rehabilitation and other aspects of his continuing practice.

The federal court judge ruled that under the terms of his policy and California law, the amount of money he was making was not relevant to his entitlement to his own-occupation disability benefits and that the issue was simply whether or not he could still perform his duties as an orthopedic surgeon. He clearly could not.

The case was settled for over $3Million.