Colonial Life & Accident Insurance Co.

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Romi of Baton Rouge LA (9/30/03):
I had been a teacher in East Baton Rouge Parish for more than 12 years. Two years ago, I started undergoing medical treatment for a painful knot in my back caused by work-related stress. (I still have knot.) On July 26, 2002, I went to a physiatrist (physical medicine specialist), who gave me one of a series of treatments, an epidaural injection in my spine (under an x-ray machine) to relieve the pain.

He made a mistake in administering the anesthetic prior to the epidaural, and injected the anesthesia into an artery. It went to my brain and I was in coma for five days. I was in the hospital for three weeks: I was totally disoriented when I regained consciousness and did not recognize my husband and daughter. I had months of physical rehabilitation, and right now I am seeing a physical therapist who specializes in balance and vertigo, Dr. Charles Plishka.

I have permanent disabilities dating from that injection by the doctor. I have no balance, and have almost total hearing loss in one ear, memory loss and extreme mental confusion. I have been under treatment by Dr. Stephen Zuckerman, a neurologist, this entire time.

It was only after last Christmas that I was coherent enough to begin to apply for a disability retirement. For all these reasons, and because I can no longer drive (I suffer from extreme vertigo), I was approved for teachers' disability retirement this summer (my first check was 8-1-03). I had been paying for disability insurance after I found out that I would have been covered by disability insurance when I had my daughter by C-section in 1991 and had to stay off work for a month. The insurance promised I would get $1000/month if I was disabled.

It has been very difficult to get the insurance company to honor their word. I received one check from them for $5000 last winter--it came in very handy. But to get a check each month I am supposed to go to Dr. Zuckerman (which is a hassle for my husband to take off from work and drive me there) all over again, even though my condition has not changed. Dr. Zuckerman has documented that on one occasion, they lied and said he had not sent the papers when he had. Now they have done this again. They called me TWICE this month and told me by automatic recording that they were processing my claim, but I have not received anything from them.

My husband took the paper to the doctor to sign at the beginning of August and yesterday I called them and told them if I don't hear from them by Friday I would take action. I do not want to continue this policy, but I still have many medical bills and need to have one more check.

I have just settled out of court with the doctor, who admitted negligence. But the legal system takes time, and the settlement check to me from my lawyer has not cleared at the credit union yet. Please advise me on what I need to do. P.S. Last summer I gave the insurance company automatic withdrawal rights from my bank account in order to keep the policy active (previously the premium was deducted from my paycheck). Now, they take my money, but have not replied when my doctor sends them the forms they require each month to document my disability.

My husband believes that I should wait until they give the insurance payment they are processing, but I believe I should stop their automatic withdrawal immediately. I don't know what to do. I think they may tell you everything will be taken care of, but then continue to procrastinate. I should also mention that they have never said in any correspondence that the coverage wasn't for PERMANENT disability.

Economic damage: disabled and out of work since July 26, 2002. I have not received the full amount of disability insurance I paid for: 14 months @ $1000 = $14000. Minus payments they have given me: $990.00 (I deposited in my acct. on 5/19/03) + $5,056.67 (deposited 3/10/03) + $756.67 (deposited 12/26/02) =$7,176.66. Minus: their charge to send by Federal Express = 3 checks X $10 = $40 Grand Total = $7,166.66 as of this date (9/30/04)

We hope and assume that Romi had an experienced and aggressive attorney handle her settlement with the doctor. She should also unleash her attorney on the insurance company. We would advise against canceling the disability policy at this point; in other words, she should NOT stop the automatic withdrawal. The company is obligated to pay her and she should not endanger her right to payment by withholding her premium payments.

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