Doyle has filed suit against Central United Life Insurance on behalf of a policyholder whose cancer treatment was denied. The policyholder had purchased a cancer insurance policy long before her diagnosis of breast cancer and continued to pay the premiums during her treatment and recovery.
Upon receiving the policyholder’s claim for benefits, Central United failed to assign her claim to an adjuster and failed to even research or request any information reasonably required to adequately investigate her claim further. The company did not conduct a reasonable and objective investigation of the facts of the claim. Further, Central United ignored medical evidence, including records from the treating doctors, and failed to collect or analyze other evidence related to the claim for insurance benefits.
In 2011, the company completely denied the claim for insurance benefits under a policy which expressly provided comprehensive coverage in the event of a cancer diagnosis. The plaintiff had maintained the policy in full force and effect by timely payment of insurance premiums for more than a decade.
Central United violated the Texas Insurance Code by refusing to pay the claim without conducting a reasonable investigation with respect to the claim. This conduct also breached the duty to deal fairly and in good faith with the policyholder. Central United acted fraudulently in denying the coverage benefits.
Doyle stands behind this policyholder in their fight against an insurance company’s bad behavior and failure to honor their financial obligation.
