One of MillBrook’s clients is a woodworking company in Northampton. For nearly 10 years, they have been a MillBrook Benefits client. We help them with all of their health and welfare plans, including a group short term disability policy.
One of the company’s employees was the victim of a physical assault that left him hospitalized and in need of surgery to repair broken bones in his leg. He was out of work for almost 4 months, and had no money coming in to pay his bills.
The insurance company denied his disability claim, citing a clause in the contract that excludes claims for injuries that occur due to participation in an assault.
The owners called MillBrook Benefits to see if we could help. Pete obtained the proper HIPAA authorization and gathered both the medical and police records. It seemed clear that the employee was the victim, not the aggressor. Pete got in touch with the claims examiner, explained the situation, supported his argument with the police report, and got the claim approved