Kansas City Life Insurance Co. denied the short- and long-term disability applications of a nurse anesthetist who was allegedly taking Fentanyl on the job. The insurer said that the reason the claimant lost his job was a failed drug test after coworkers reported he...
appeal denied insurance
Social-media surveillance of disability claimant’s activities
We recently posted information in this space about how disability insurers use surveillance to investigate the lifestyles of their disability claimants to try to uncover evidence that the claimants’ activities are inconsistent with the medical conditions...
Policy language limits disability insurer administrator’s power
A recent court opinion sheds light on the ramifications of disability insurance policy language that describes what powers the insurer's administrator has to decide claims. We recently posted a blog about the standards of review courts apply when considering an appeal...
What is a disability insurer’s structural conflict of interest?
A large insurance company that sells short- or long-term disability coverage can intimidate an individual fighting for their rightful benefits after having become disabled. When that insurer decides its own claims internally, rather than outsourcing that...
Court holds LTD claimant did not have a pre-existing condition
On Sept. 3, the U.S. Court of Appeals for the 1st Circuit held that Aetna had wrongly denied long-term disability insurance coverage to a claimant with malignant melanoma. The opinion turns on a legal issue that comes up often in LTD cases — whether the claimant...
Man with severe heart condition denied disability by Cigna
When Florida residents have a medical disability that keeps them from working, they often depend on their disability insurance to help them financially survive. Unfortunately, insurance companies sometimes refuse to pay, leaving people between a rock and a hard place....
Common exclusions found in life insurance policies
Florida residents and others looking to purchase life insurance should understand that policies are binding contracts. Therefore, they may contain exclusions or exceptions that buyers need to look for prior to making a purchase. The exclusions or loopholes included in...
Distinguishing between PTSD and TBI for your disability claim
When a person is unable to work due to a medical condition, he or she may need certain types of financial support. If you find yourself in this position, you may understand first-hand how complicated it can be to navigate the process of recovery, from getting the...
NFL Disability Claims
The National Football League is well known for denying the valid disability claims of its players. After submitting a claim for disability benefits to the NFL, which is self-insured and administrates all NFL claims, the player is often sent to numerous "neutral"...
Fighting back against disability claims denials
When Florida residents file claims with their private or group disability insurance, they may be surprised to find themselves confronted with delays or denials of the claim. This can be devastating as people often rely on these insurance policies to provide...