What types of physical conditions does disability insurance cover?
Disability Insurance Law Blog
by On Behalf of Disability Insurance Law Group
5d ago
If you have a disability insurance policy, it is important to understand what that policy covers in case you ever lose your ability to work due to an illness or physical injury. Policies differ with regard to the type of conditions covered, the length of time of coverage, and exceptions that may apply. Below are examples of terms and conditions that vary. Not applying for the appropriate benefit could result in a claim delay or denial. Total vs. partial disability Insurance companies often define a disability as a Total Disability or a Partial Disability. Depending on the Policy, a Partial Dis ..read more
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What you need to know about your Accidental Death and Dismemberment (AD&D) Insurance Policy
Disability Insurance Law Blog
by DI Law Group
4M ago
Each year, millions of Americans pay insurance companies for coverage, trusting that if the unexpected happens, the terms of the policy will be honored and their claims will be paid. One type of policy is Accidental Death and Dismemberment insurance. What Is Accidental Death and Dismemberment (AD&D) Insurance? An AD&D insurance policy is exactly what its name indicates - a policy that covers a policyholder in the event of death or dismemberment. This policy is typically added as a rider, or additional coverage, to a health insurance or life insurance policy. It can be provided through ..read more
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What you need to know BEFORE appealing a short-term or long-term disability insurance claim…
Disability Insurance Law Blog
by DI Law Group
8M ago
Your insurance claim has been denied, now what? Dealing with insurance claims that have been denied can lead to frustration, confusion, and discouragement. The reality is, the appeal process can be complex and leave you feeling overwhelmed. We are here to help. First, it’s important to understand that if you obtained your short-term or long-term disability policy through your employment, ERISA (the Employee Retirement Income Security Act of 1974), a federal law, likely applies to your claim. What does this mean? It means that you must follow certain procedures when filing for benefits or when ..read more
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Delay and deception: Disability insurer tactics in claim denials
Disability Insurance Law Blog
by On Behalf of Disability Insurance Law Group
8M ago
Insurance companies that sell short- or long-term disability insurance policies are in business to make a profit. It follows that they are not necessarily there to be benevolent supporters of their policyholders when they struggle with disabling health conditions. To that end, it is unfortunate that most disability insurers have the same arrows in their quivers – a set of underhanded claim processing tactics used not to reach the right decision on a disability claim, but rather to figure out a way to deny it (or to terminate a claimant already receiving benefits). Many people never have to dea ..read more
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Did your disability insurer weaponize an independent medical exam?
Disability Insurance Law Blog
by On Behalf of Disability Insurance Law Group
9M ago
Most disability insurance policies allow the insurer to arrange for a reasonable, relevant independent medical examination (IME) of the claimant. While on its face this sounds fair and even potentially helpful for a disability claimant, the insurance company may use IME findings to deny a claim or terminate disability benefit payments, even in the face of the claimant’s own strong medical evidence. IME Bias A physician who performs numerous IMEs for insurance companies may have an inherent conflict in that they are often paid well by the insurance company to assess a claimant’s functionality ..read more
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Interpleader suits to determine rightful life insurance beneficiaries
Disability Insurance Law Blog
by On Behalf of Disability Insurance Law Group
10M ago
Life insurance seems straightforward. You buy a policy or get one through your employment that will pay money to your beneficiary after your death. You name your beneficiary or beneficiaries as part of the enrollment process and normally can change your beneficiary choices over the years as relationships evolve or people pass away. Unfortunately, sometimes after a life insurance policyholder has died, the insurance company may not be able to determine the proper beneficiary. Or a dispute develops among two or more people who believe they are the rightful beneficiaries. At this point, life insu ..read more
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Business interruption insurance in the time of COVID-19
Disability Insurance Law Blog
by On Behalf of DI Law Group
11M ago
Many businesses of all types and sizes have business interruption policies as part of their insurance portfolios to protect their livelihoods in case of sudden inability to continue doing business because of outside forces. Most commonly, business interruption insurance pays out to the commercial policyholder in case of a disaster like a hurricane, wildfire or tornado that causes loss of business earnings and raises costs. Of course, many restaurants, retailers, entertainment providers, nonprofits and service companies are currently shuttered or operating at a greatly reduced capacity because ..read more
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Challenges in a disability insurance claim based on PTSD
Disability Insurance Law Blog
by On Behalf of DI Law Group
11M ago
In this time of COVID-19, many people are experiencing extreme stress, even trauma, as first responders, medical personnel, those susceptible to the new coronavirus because of advanced age or underlying medical conditions, those who do become ill and those facing financial loss – and the families and loved ones of all of these people. After these disturbing experiences, some will develop posttraumatic stress disorder (PTSD). In addition, InStyle reports that both people facing COVID-19 directly in their lives and those quarantining at home are “all susceptible to long-term mental health issues ..read more
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LTD insurer may not arbitrarily discredit treating doctors’ opinions
Disability Insurance Law Blog
by On Behalf of DI Law Group
11M ago
On March 22, 2021, the U.S. District Court in the Western District of Washington ordered Prudential to pay long-term disability (LTD) benefits to the claimant, a software engineer who said he was unable to work based on mental impairments that developed after abusive treatment at work. In Chapin v. Prudential Insurance Company of America, the judge found the opinions of Chapin’s treating doctors and therapist that the claimant was disabled from working as well as objective cognitive testing “compelling at the outset.” The three treating professionals consistently diagnosed anxiety and depressi ..read more
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Disability insurers use aggressive surveillance to deny claims
Disability Insurance Law Blog
by Disability Insurance Law Group
1y ago
Using a variety of surveillance and investigation techniques, disability insurance companies often try to gather information about claimants’ daily activities. Then, they use the information to say the claimants are not disabled – and not eligible for disability benefits. For example, the insurer might deny a disability claim by saying that because social media postings show the claimant enjoying themself at a party, they could not be disabled from depression. Or, the insurance company may assert that because a claimant mows their lawn, they are not in disabling pain. By using surveillance to ..read more
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