How is Business Overhead Expense Insurance Different Than an Individual Disability Policy?
Jan 9, 2019 | Blog | ShareChicago Insurance Attorney If your business is covered by private business overhead expense (BOE) insurance, you may be wondering how a claim brought under the BOE insurance plan differs from a disability benefits claim. Business overhead expense insurance is a unique and somewhat non-standard form of insurance that covers small and medium-sized businesses in the event that a valuable individual — typically the owner, but sometimes a different employee within the company — is disabled and therefore can’t work for the company. The benefits payout from a BOE insurance plan can help a business survive until the disabled employee recovers […]
Variable Income and Disability Insurance Coverage
Dec 19, 2018 | Blog | ShareChicago Disability Lawyers If you work as a freelancer, salesperson, or in some other capacity where your income is variable on a day-to-day, week-to-week, or month-to-month basis, then you may be concerned about the potential impact on your disability insurance plan and the benefits that you are entitled to receive (in the event that you do actually suffer a disabling injury, illness, or condition). Policyholders with variable income may find they are at something of a disadvantage. Insurers are constantly looking to minimize their costs, and if you have a variable income, they will almost certainly look to underestimate your […]
What Happens to Life Insurance Proceeds if the Primary Beneficiary Dies Before the Insured?
Dec 4, 2018 | Blog | ShareIf you’re a life insurance beneficiary — primary, secondary, or tertiary — then you may be wondering how proceeds will be distributed if one of the other beneficiaries has died before the insured. When a primary beneficiary die before the insured, this can cause a significant shift in the distribution of proceeds and may impact the claims that various beneficiaries have to the death benefit. Let’s explore. Unclaimed Proceeds are Paid to the Estate Suppose that the life insurance policy listed only a single, primary beneficiary, and that beneficiary died before the insured, or perhaps simultaneously — for example, the […]
Common Life Insurance Beneficiary Disputes
Dec 4, 2018 | Blog | ShareIn the context of life insurance, it’s not at all that uncommon for the beneficiaries to be in conflict with one another — after all, the benefits amounts may be significant, and there may be inconsistencies in the distribution of benefits that were not known to the beneficiary prior to the death of their loved one. For example, the spouse of the deceased may be surprised to find that the first wife of the deceased was actually the beneficiary at time-of-death, and therefore has a legitimate entitlement to the benefits at-issue. This can quite clearly give rise to a dispute. If […]
Seventh Circuit: ERISA Plan Can Be Penalized for Failure to Disclose Fee Schedules and Rate Tables used to Determine Usual, Reasonable, and Customary Rate
Dec 4, 2018 | Blog | ShareBy: Andrew B. Bryant How insurance plans determine “usual, reasonable, and customary” pay rates for healthcare claims submitted by out-of-network (“OON”) providers is a frequent bone of contention in medical reimbursement disputes. In the recent matter of Griffin v. Teamcare, the Seventh Circuit addressed the issue of whether a medical provider who had obtained an assignment of benefits from a patient was entitled to request, and receive, the data underlying the Plan’s decision-making process as to rate of pay for OON services. In the case, Dr. W.A. Griffin contacted the Plan prior to delivering treatment to the insured patient. The […]
Disability Insurance: Insurers May Conduct Surveillance
Nov 30, 2018 | Blog | ShareIf you’ve submitted a claim for disability benefits with your insurance company or are interested in challenging the initial denial of benefits – whether such benefits are available through an individual plan or a group plan – then there’s a chance that your insurer will conduct surveillance on your activities. Surveillance evidence (photos, video, text, audio, etc.) can be used to call into question the severity of your disability and could damage your ability to secure the benefits you’re rightfully owed. Insurers May Conduct Surveillance In the past, insurers would sometimes hire investigators to perform initial surveillance of disability claimants. […]
The Tax Consequences of Long-Term Disability Benefits
Nov 6, 2018 | Blog | ShareWhether you’re interested in submitting a claim for long-term disability benefits, are currently involved in a long-term disability insurance dispute, or have already secured benefits, chances are that you’ve at least considered the tax consequences of such benefits. In the private disability insurance context, plans can vary quite a bit, and as such, the tax consequences of receiving benefits can rather different from plan-to-plan. Let’s take a brief look at the basics. Basics of Long-Term Disability Income Taxation When you sign up for long-term disability coverage — whether your plan is provided through your employer or was purchased individually — […]
Notifying the Insurer of a Change in Circumstances
Nov 6, 2018 | Blog | ShareIn Illinois — and elsewhere — private disability insurance beneficiaries may find themselves in a somewhat confusing situation as they make significant progress over the course of their rehabilitation and recovery process. The source of this confusion is in the push-pull relationship between two fundamental issues in the disability context. Disability benefits recipients are entitled to benefits only if their condition is suitably disabling such that they are incapable of working, but they also have a duty to mitigate their losses. In other words: those who receive disability benefits must strive to recover from their disabling condition. They must consistently work […]
What Does it Mean to Exhaust Your ERISA Administrative Remedies?
Oct 31, 2018 | Blog | ShareGroup disability insurance policies often come under the umbrella of the federal Employee Retirement Income Security Act (ERISA), which establishes a separate regulatory scheme for such benefits plans. Policyholders in ERISA-governed disability plans are subject to a number of unique limitations and entitlements that can seem confusing to those who do not have prior experience handling claims and disputes in the group insurance context. ERISA-Governed Plans and the Administrative Exhaustion Principle If your plan is governed by ERISA — in other words, if your disability insurance plan is employer-sponsored and your employer is neither a public entity nor a qualified […]
Common Reasons for Denial of Short-Term Disability Benefits
Oct 31, 2018 | Blog | ShareIn the short-term disability insurance context, it’s rather common for disability claimants to feel as though their insurer is mishandling their claim — and this belief is certainly not formed without good reason. Insurers are fundamentally incentivized to deny, delay, and otherwise mishandle short-term disability claims so that they don’t have to payout the benefits that you are rightfully owed. Short-term disability claimants, generally speaking, are less likely to push forward and attempt to secure benefits when the insurer has denied a claim, as the claimant is likely attempting to recover as soon as possible from their condition and return […]