Third Circuit: “Own Occupation” and “Regular Occupation” Interchangeable
Apr 10, 2019 | Blog | ShareChristopher Patterson v. Aetna Life Insurance Company, No. 17-3566 (3d Cir. 2019) By: Stephen A. Jackson Patterson became disabled after back surgery and Aetna began paying benefits under a group long-term disability plan in 2007. In 2014, Aetna terminated those benefits after concluding Patterson was no longer disabled because he could fulfill the material duties of his “own occupation” as performed “in the national economy.” The term “own occupation” was not defined in the policy. Aetna determined Patterson’s “own occupation” “in the national economy” was sedentary and that while he could not do a job in a “heavier category” he […]
Do You Know the Deadline for Filing Your ERISA Claim?
Apr 9, 2019 | Blog | ShareDo You Know the Deadline for Filing Your ERISA Claim? Even if You Think You Do, You May Be Wrong While ERISA claims come with many obstacles, one of the most challenging is a disability insurance company’s right to shorten their plans’ appeal deadlines. Unfortunately, courts won’t give disabled workers and professionals who miss these deadlines much (if any) leeway. Unfortunately, once a deadline expires, it’s usually too late, and you’ll lose your right to benefits. The team at Bryant Legal Group is happy to meet with people who have missed their appeal deadline and will be there to guide […]
Multiple Sclerosis and Disability Insurance: A Claimant’s Guide
Apr 3, 2019 | Blog | ShareA multiple sclerosis (MS) diagnosis leads to a lot of questions, and you’re likely hearing conflicting information about your chances of receiving long-term disability (LTD) benefits. Keep reading to learn more about LTD benefits for MS, why this process is so complicated, and how you can strengthen your claim. What Is Multiple Sclerosis (MS)? Multiple sclerosis is a disease of the central nervous system that causes your immune system to attack your myelin, a fatty substance that covers and protects your nerves. When myelin is lost or damaged, plaque or scarring builds up on the nerves, making it more difficult […]
Individual vs. Group Disability Income Insurance
Feb 15, 2019 | Blog | ShareChicago Disability Lawyers Whether you have purchased individual or group (i.e., employer-sponsored) disability coverage can have a significant impact on your premiums, duties, and — eventually — ability to recover benefits. Many would-be insureds do not realize that there are material differences between individual and group disability insurance coverage, and simply choose a plan based on the projected cost. Though cost is a perfectly reasonable factor to consider when choosing a disability policy, it’s also important to evaluate how the unique aspects of each policy might affect its “true value” given the circumstances. Consider the following. ERISA Qualification Group disability […]
Life Insurance: Understanding Pre-Existing Conditions
Feb 8, 2019 | Blog | ShareChicago Life Insurance Attorney Life insurance claims can be significant, and as such, they are often denied. Beneficiaries may be taken by surprise, thinking that the act of securing benefits would have been straightforward. In truth, however, insurers will take advantage of any opportunity to justify the denial of a significant benefits payout, in the life insurance context and otherwise. Many life insurance claims are denied on the basis of the individual covered by the policy (the deceased individual) having failed to properly inform the insurer of a pre-existing condition that would have led to a higher premium rate or […]
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 […]
