In a recent case out of the Southern District of Florida, the district court held that while the PNC Plan provided PNC with discretion to determine questions of coverage and eligibility for benefits, there was not a proper grant of discretion to the third-party...
Holding Insurance Companies Accountable For The Coverage They Promised And The Benefits You Deserve
Helping People Like You With Their Disability, Life And Long-Term Care Benefit Claims
Appealing A Claim Denial
Eleventh Circuit Court of Appeals Finds that Reliance Standard Life Insurance Company Acted Unreasonably When it Denied Disability Insurance Benefits Under the Pre-Existing Condition Exclusion to a Woman Who Suffered a Stroke Nine Days After Giving Birth
Julissa Bradshaw had a healthy pregnancy and no other pre-existing medical conditions when she became insured under her ERISA governed disability insurance policy with Reliance Standard Life Insurance Company ("RSL"). Approximately six months after obtaining the...
Disability Insurance Law Group Appeal Results in MetLife overturning Denial of Benefits for Depression and Anxiety Claim
Our client (Mr. X), a stockbroker in New York, experienced anxiety and major depression as the result of family related issues and the death of his mother after her long battle with cancer. His treating psychiatrist and therapist both advised him to avoid as much...
Cognitive and Mental Health Conditions Are Not Always Subject to a 24 Month Maximum Benefit Cap
Many group Long Term Disability policies limit the payment of benefit to 24 months if the disability is "due in whole or part to mental illness." However, insurance companies can be quite liberal with this language and apply it to claims where there are cognitive...
The First Circuit Court of Appeals Determines that Standard Insurance Company Acted Unreasonably Denying a Claimant Benefits, Where it Failed to Consider the Claimant’s Actual Occupational Duties.
In a recent case, the First Circuit Court of Appeals determined that Standard Insurance Company acted arbitrarily and capriciously when it denied an environmental attorney with severe depression Long-Term disability insurance benefits. The claimant was an equity...
Proving Disability from Depression, Anxiety, and other Psychological Conditions
As many insureds suffering from depression and/or anxiety can attest, filing a disability insurance claim based on these illnesses can be complicated and frustrating. Because "objective evidence" of depression and anxiety is not always readily available, these claims...
A Short Term Disability Denial or Determination Delay Does Not Preclude a Claim for Long Term Disability Benefits
Many insureds are discouraged from pursuing a claim for long term disability benefits prior to receiving an approval of short term disability benefits or after receiving a submitting an appeal of short term disability benefits. A potential problem with simply waiting...
Disability Insurance Law Group Overturns Cigna’s Denial of Disability Benefits in Time for Claimant with Fibromyalgia to Save her Home
Our client, Ms. W, enjoyed a long and successful career as an office manager for a mid-size company. Unfortunately, shortly after receiving a promotion, she began to experience unusual and troubling symptoms such as extreme fatigue, severe pain in her joints,...
Disability Insurance Denial Answers
Insurance Companies such as Aetna, Assurant, Berkshire, Cigna, Guardian, Liberty Mutual, MetLife, Reliance, Standard, and Unum are well-known for unfair and biased claims review processes, misrepresenting the facts, and for denying valid disability benefit claims....
How a Disability Insurance Attorney Can Assist in the Administration or Appeal of a Disability Claim
Dealing with an insurance company at any stage of the disability claims process can be complicated, frustrating, time consuming and confusing. Whether you are applying for disability benefits, waiting for a claim determination, on claim, appealing a denial...