Court Questions if Insurer Actually Watched Video Surveillance Used to Deny LTD Claim, or Just Read the Report By: Andrew B. Bryant In our September 2, 2018 blog article on the use of video surveillance in an insurer’s investigation of a disability claim, we saw how video surveillance of a long-term disability (LTD) recipient’s daily activities significantly contradicted statements made by that benefit recipient, and ultimately discredited the claim for LTD benefits. A recent District Court decision out of the Central District of California shows the flip-side – how an insurer’s reliance on video surveillance (or in this case the […]
ERISA Appeal Best Practices
Feb 1, 2019 | Blog | ShareExperienced ERISA Denial of Benefits Attorney The Employee Retirement Income Security Act (ERISA) was enacted in the 1970s with the intention of protecting plan beneficiaries from fund mismanagement and fiduciary manipulation, but has now grown into a much broader regulation that covers all aspects of the benefits claim submission and administrative appeal (through Department of Labor regulations), and litigation processes. If you are a plan beneficiary in an employer-sponsored benefit plan (e.g. disability, life, retirement, health, etc.) then there’s a good chance that your benefits are governed by ERISA–the unique set of rules that apply to such plans. These rules can […]
Wrongful Denial of Benefits for Long-Term Care
Jan 17, 2019 | Blog | ShareThough many policyholders forget, it’s important to recognize that insurers are always looking to maximize their profits — and this typically involves a strategy of minimizing their expenses by developing policies that justify the denial of seemingly legitimate claims. The easier it is to justify the denial of an insurance claim, the less likely it is that the policyholder will challenge the decision. This enables the insurer to avoid having to payout for claims that are actually recoverable. Long-term care insurance policies are no exception to this rule. In fact, long-term care can be quite expensive for an insurer to […]
Disability Claimants Must Seek Timely and Adequate Care to Secure Full Benefits
Jan 16, 2019 | Blog | ShareChicago Disability Lawyers: Helping You When You Need it Most If you’re suffering from a disability and are thinking about submitting a claim for benefits to your private disability insurer, or have already submitted a claim and had it denied, delayed, or otherwise mishandled, then you may be feeling somewhat overwhelmed. In the wake of a serious disability, it’s quite common to be “financially squeezed” due to the cost of treatment and the loss of income from being unable to work. Given the emotional and financial burdens experienced by many disabled policyholders, it’s rather common for such individuals to delay […]
Unconscionable Provisions in Insurance Contracts
Jan 15, 2019 | Blog | SharePolicyholders — health, disability, property, etc. — may sometimes find that the insurer has an unreasonable amount of power over them, perhaps more than they anticipated when they purchased the policy years before. This is unsurprising. Insurers often design and execute unfair contracts that are designed to put the policyholder in a distinctively weakened position comparatively. If you’ve had your claim denied or mishandled due to an underlying contract provision that you believe is unreasonably oppressive, then you may have a right to bring a lawsuit against your insurance carrier on the basis of “unconscionability.” Let’s explore how unconscionable contracts […]
Cost of Living Adjustments and Disability Insurance Coverage
Jan 14, 2019 | Blog | ShareThough your disability claim may be airtight, recovering benefits through your private disability insurance policy is not necessarily the “endgame.” What may seem to be an adequate recovery could be rendered inadequate years later if your benefits are not adjusted for cost of living increases. After all, one dollar in 2018 is worth significantly less than one dollar in the year 2000. Disability policyholders who are concerned about the sufficiency of their coverage over the long-haul can purchase a supplemental cost of living adjustment (COLA) rider that will result in a steady increase in their benefits as time passes. Let’s […]
Common Issues in Business Overhead Expense Insurance Disputes
Jan 11, 2019 | Blog | ShareChicago Insurance Attorney Insurers frequently act in ways that are hostile to the interests of a policyholder, in part because they hope that they can reduce their liabilities by forcing a policyholder to stop pursuing an otherwise legitimate claim for benefits. This is especially true in the business overhead expense (BOE) insurance context, where the payouts can be quite significant (depending on the circumstances). BOE insurance benefits can be critical for enabling a business to survive until the covered individual recovers from their disabled condition, or until a transitionary decision can be made (and a plan executed). If you’ve had […]
Building a Comprehensive Application for Disability Benefits
Jan 10, 2019 | Blog | ShareChicago Disability Lawyers If you’ve been disabled — due to an injury, illness, or other condition — and are submitting a claim for benefits pursuant to your private disability insurance plan, then it’s important that you work with an experienced attorney to coordinate with stakeholders and help you put forth a comprehensive application for disability benefits. Failure to submit a comprehensive application for benefits could give the insurer justification for denying an otherwise legitimate disability claim and set you back quite a bit (with regard to timely recovery of benefits). Disability Claims Are Frequently Denied In both the public and […]
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 […]
