Pizzeria owner suffering from Celiac disease filed lawsuit against Berkshire for breach of contract in refusing to pay disability benefits
Recently a lawsuit was filed against the Berkshire life Insurance company of America at the Circuit Court for the County of Wayne in Michigan by an owner and operator of several pizzerias through his disability attorney. The disability lawsuit was filed after Berkshire evaluated the disability claim and made a determination that the claimant was not disabled.
The Facts of the Case:
The plaintiff Patrick Buck purchased an insurance policy on March 15th 1990 with Berkshire Life that included total disability coverage. On April 17th 2008, the plaintiff was diagnosed as suffering from Celiac disease. Celiac disease is a type of disease that affects the small intestine which hinders with absorption of nutrients from food. Individuals who suffer from Celiac disease are not able to tolerate gluten, a vegetable protein that is found in Barley, Rye and Wheat. Symptoms of the disease include:
- anemia
- fatigue
- bone or joint pain
- arthritis
- bone loss or osteoporosis
- depression or anxiety
- numbness in the hands and feet
- seizures
- irregular menstrual periods
- infertility or recurrent miscarriage
- sores inside the mouth
- dermatitis herpetiformis
In addition, individuals affected by celiac disease can also suffer from other diseases in which the immune system attacks the body’s healthy cells and tissues. The connection between celiac disease and these diseases may be genetic. They include
- Addison’s disease
- Diabetes (Type 1)
- Liver disease
- rheumatoid arthritis
- Sjorgen’s Syndrome
- Thyroid disease
Due to his medical conditions, the plaintiff was instructed by his attending physician to avoid contact with all gluten products. The plaintiff informed Berkshire Life in writing of the situation and submitted a disability statement requesting disability income benefit payments as per the terms under the life insurance policy issued by Berkshire Life.
Despite having kept and complied with all the terms, requirements and conditions stipulated in the disability insurance policy, Berkshire Life refused to pay any disability benefits to the plaintiff. Reasonable proof supporting the plaintiff’s claim was also submitted to Berkshire Life. However, even after through many repeated requests for payment, Berkshire Life still refused to make disability income benefits payments to the plaintiff according to the policy.
Relief sought by the Plaintiff under the Lawsuit
In the lawsuit, the plaintiff argued that because of the failure of Berkshire Life to honor its contractual obligations, Berkshire is in breach of the contract between it and the plaintiff. As such the plaintiff is seeking from the Court:
- A declaration that Berkshire Life is liable to pay the plaintiff disability income benefits
- Judgment against Berkshire Life for compensatory and exemplary damages which the plaintiff is entitled to inclusive of interest, attorney fees and any penalties that are provided by the law
- A speedy hearing of this lawsuit
- A trial by jury
Notice of Removal:
Berkshire Life on April 19th 2011 in response to the plaintiff’s lawsuit, filed a motion for the case to be removed and heard in the Federal District court for the Eastern District of Michigan instead of State Court. It is not uncommon for a disability insurance company to prefer to have a case in federal court rather than state. Our disability law firm prefers to handle disability lawsuits in federal court.
Resources to Help You Win Disability Benefits
Disability Benefit Denial Options
Submit a Strong Berkshire Appeal Package
We work with you, your doctors, and other experts to submit a very strong Berkshire appeal.
Sue Berkshire
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Berkshire.
Protect Your Benefits
Get Your Berkshire Disability Application Approved
We help claimants throughout the entire application process.
Prevent a Berkshire Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.
Negotiate a Berkshire Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Berkshire Reviews
(660)
Policy Holder Rating
5
0%
4
0%
3
0%
2
0%
1
0%
Timely Payments
0.0out of 5
Handling Claim
0.0out of 5
Customer Service
0.0out of 5
Dependable
0.0out of 5
Value
0.0out of 5
Showing 8 of 660 Reviews
Lincoln Financial
Uses every dirty trick in the book
It’s next to impossible to get $ out of them without a lawyer. They use plenty of intimidation and unfair tactics. They don’t want to pay. And yet, their CEO made 13 m... read more >
Unum
Unum is evil
On 11/3/2021 I got shot by my boyfriend and my spinalcord got hit, paralyzing me from the neck down and accepting Unum benefits was the worst decision I ever made. I sued ... read more >
Lincoln Financial
Every month I get paid on a different date
I will start by saying that my experience is not as horrible as others, like the folks who have valid claims but get nothing from Lincoln. I feel for you and hope to god y... read more >
MetLife
They will do anything to not approve your claim
MetLife’s handling of my short-term disability claim has been incredibly frustrating and stressful. I followed all the necessary steps prior to my surgery, providing the... read more >
Reply
Sedgwick
Don't trust them, they like to play games
They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >
New York Life
Lyme Disease Disability Claim Denial
I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >
New York Life
Disappointed with NY Life Disability Excuses
I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >
New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
Answered Questions by Our Lawyers
(2)
Showing 2 of 2 Answered Questions
Q: Are you familiar with the difference between Berkshire’s Enhanced and Basic residual contract language and how material the language difference could be at claim time?
A: Chris, thank you for asking this important question. Without actually seeing the exact policies that you are r... Read More >
Q: Does Berkshire offer lump sum buyouts of uncontested disability claims?
A: Joe, From our experience, Guardian/Berkshire does not offer lump sum buyouts of uncontested disability claims.... Read More >
Helpful Videos
(910)
Showing 12 of 910 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >
How Do You Fight a Long-Term Disability Denial?
Getting a denial letter from your disability insurance company is one of the ultimate insults. You are sick and not able to work, yet your disability insurance company is telling you to return to work. The disability insurance company has denied your disability benefit claim and is basically calling you a liar. When receiving a disability denial letter or a ph... Read More >
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
One of the top reasons for terminating a claimant's long term disability benefits involves the change in the disability insurance policy's definition of "disability." This definition change often happens in conjunction with a vocational review, or an analysis of a claimant's medical records that tells the insurance company which jobs the claimant should be able ... Read More >
Disability Denial Reason #1 – Paper Review & IME
At Dell Disability Lawyers, we've seen insurance companies give countless reasons to deny long term disability benefits. However, most disability benefit denials tend to fall into one of a few categories - and one of the biggest ones is the paper review and independent medical exam (IME). Learn more about what this review process entails and what your claim file... Read More >
How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial
At Dell & Schaefer we’ve handled hundreds of long term disability insurance claims against Reliance Standard, and have learned a few things in the process. When you’re experiencing an injury or illness that makes it difficult (or impossible) to work, it can be tempting to file a claim as quickly as possible – but unless a claimant has all their ducks in a row, this could actually delay the ultimate r... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases
Berkshire Approves Application for Disability Benefits to Sales Manager
Our client, an accomplished outside salesman, had built a stellar reputation in his industry after building his company over a period of many years and then after he sold the business to an international company, and continued to work in his capacity as a salesman. Throughout his entire career he was always focused on building relationships with his clients and despite his role as the owner, was always traveli... Read More >
Berkshire and Liberty Mutual approve benefits to OB/GYN suffering from essential tremor
Our client, an OB/GYN purchased long term disability insurance policies from Berkshire and Liberty Mutual in hopes that he would never need to file a disability claim. He began experiencing a slight tremor in his left hand in 2006. At that time he sought treatment to determine the origin of the tremor and his options for treatment. It was initially determined that the tremor was minimal and was not impacting h... Read More >
Berkshire approves total disability benefits for litigation attorney following surgery to remove a cancerous tumor and multi-level fusion of cervical spine
Our client was a litigator with his own successful practice. Early in 2009 he began to experience increasing pain in his upper back and neck. Thinking it was just a result of stress, he continued to try to work through the pain. As the pain worsened he sought medical treatment and later learned he had a life-threatening Chordoma in his cervical spine.The slow growing, highly dangerous Chordoma had to be re... Read More >
Berkshire Life Insurance Company approves long-term disability benefits for a dentist suffering from lumbar disc disease
Our client, a general dentist, purchased a long-term disability policy from Berkshire Life Insurance Company of America. The policy defined "disability" as the inability to perform the substantial and material duties of his regular occupation. Our client maintained a solo dental practice since 1995. After several years of practice, Dr. Q began experiencing back pain which made it difficult for him to bend over... Read More >
Seven Surgeries and The Standard Still Denies Disability Insurance Benefits
Our client was employed with the State of Oregon as a Technical Support Representative. She sought disability through her employer provider LTD Policy with Standard due to low back, hip, and lower extremity pain. She had two hip, two knee and three back surgeries.After paying her for 1.5 years Standard hired a board-certified neurologist to perform a review ... Read More >
Sun Life Wrongfully Denies Disability After Paying For 23 Months
We represent a 57 year-old claimant who’s occupation was selling commercial vehicles for many years. Her job was very physical as it required her to climb in and out of semi-trucks multiple times a day as well as operate them which was very strenuous. She went out of work in due to ongoing and severe debilitating right hip, low back, and bilateral knee pain... Read More >
Nurse Denied Long-term Disability Benefits by Lincoln After the Definition of Disability Changed
Our client, a registered nurse for Dignity Health, found herself in a difficult situation after being diagnosed with lumbar spondylosis and left knee arthritis. She continued to work, however, struggled while attempting to work through chronic lower back pain and left lower extremity radicular symptoms on a daily basis. Sadly, her condition failed to improve and... Read More >
Lincoln Reverses Decision to Terminate LTD Benefits of Corporate Attorney after Dell Disability Lawyers Appeals the Decision
The claimant is an 64 year old former Corporate Attorney and at a prominent Florida business law firm who was forced to cease working in his highly successful and rewarding profession, job, and career on January 27, 2021, and to seek disability compensation under his policies with Lincoln due to severe symptomatology stemming from or following a viral COVID-19 i... Read More >
Disability Lawsuit Stories
(765)
Reviews from Our Clients
5 Ways We Help Get Your Benefits Paid
Get Your Disability Application Approved
Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.
Submit A Strong Appeal Package
If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.
Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
Sue Your Disability Company
98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.
We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
Prevent A Disability Benefit Denial
Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
Negotiate a Lump-Sum Settlement
Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.
Questions About Hiring Us
Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Who do you help?
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
Do you work in my state?
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
How can I contact you?
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.