Common Insurer Justifications for the Denial of Private Disability Benefits
If you are suffering from a disability and have had your benefits claim denied by your private disability insurer, then you may be entitled to bring an action against your insurer — whether your insurance coverage was purchased individually or provided as part of an employer-sponsored plan. Insurers are often quite aggressive in denying private …
“Resolving Insurance Claim Disputes before Trial” Available Now!
“Resolving Insurance Claim Disputes before Trial” published by the American Bar Association Tort Trial & Insurance Practice Section is available now. Jennifer Danish co-authored Chapter 7, Health and Disability Benefit or Insurance Claims, with JoAnn Dalrymple. The book can be ordered online at: https://shop.americanbar.org/eBus/Store/ProductDetails.aspx?productId=313723009 The content provided here is for informational purposes only and should not be construed …
Common Disputes in Short-Term Disability Insurance
Short-term disability insurance provides temporary wage replacement benefits in the event that you are suffering from a disabling condition, though the benefits apply for a very limited period of time — in most cases, short-term disability benefits are only paid out for six months to one year of proven disability. After sufficient time has passed …
Business Overhead Expense Insurance — Wrongful Denial of Your Claims
Business overhead expense (BOE) disability insurance — otherwise known as business expense insurance — serves as replacement “resources” in the event that the policyholder is disabled and is rendered incapable of working, thus resulting in diminished revenues. BOE insurance is generally purchased in situations where one (or a few) individuals are responsible for generating business …
To Assert or Not To Assert Assignment in Out-Of-Network Payer/Provider Disputes
By: David A. Bryant Two recent federal district court cases highlight the importance of properly pleading (or not pleading) assignment of rights in an out-of-network provider’s state law complaint for payer reimbursement. In the Southern District of New York, plaintiff/provider filed suit in state court against Aetna, bringing various state law claims based upon the …
District Court Upholds LINA’s Denial of LTD Benefits Due To Lack of Objective Findings of Mental, Cognitive, or Behavioral Impairment
District court upholds insurer’s denial of LTD benefits agreeing with the insurer’s file reviewer that there are no objective findings from a psychiatric standpoint that indicates the Claimant is mentally, cognitively and/or behaviorally impaired. In Gailey v Life Insurance Company of North America, 2016 WL 6082112 ( M.D. Penn. October 17, 2016), the Claimant was …
7th Circuit Court of Appeals Critical of Vocational Evidence in Social Security Disability Case
The Seventh Circuit Court of Appeals takes yet another opportunity to criticize the Social Security Administration’s disability claim adjudication process in Alaura v. Colvin, decided August 18, 2015 (decision written by Judge Richard Posner). The plaintiff, a 22-year old man was struck in the back of his head by an assailant wielding a bar stool as a weapon. The …