A director of operations suffered a heart attack and was denied short-term, long-term, and waiver of premium on his life insurance policies by Principal Financial, despite his doctor’s supportive statements and his own attempts to return to work.
The denial was based on a peer review by an internal doctor who determined the director was capable of doing sedentary work, ignoring the mental demands of his job and his secondary PTSD and other mental health conditions.
The director’s job required managing a facility, making time-critical decisions, and had physical and cognitive demands that were not considered by Principal Financial, but were later established through cognitive and physical testing.
After submitting an appeal, Principal Financial initially wanted to send the director to an independent medical examination, but eventually decided to rely on peer reviews, and ultimately approved the claim for short-term and long-term disability insurance.