Using a variety of surveillance and investigation techniques, disability insurance companies often try to gather information about claimants’ daily activities. Then, they use the information to say the claimants are not disabled – and not eligible for disability...
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long term disability
State law remedies for denied individual insurance policy claims
Different laws apply to each of two types of disability insurance policies. The first kind of policy is governed by the federal law ERISA, short for the Employee Retirement Income Security Act of 1974, which applies to almost all policies offered through employment....
Court in ERISA appeal finds classic LTD disability insurer cherry-picking
Court in ERISA appeal finds classic LTD disability insurer cherry-picking Disability insurers have an arsenal of tactics to deny or terminate disability benefit claims. One common tactic is “cherry-picking” in which the insurer or its claims administrator picks...
Nurse anesthetist with drug addiction could not work because he put patients at risk
A federal appeals court on April 5, 2021, agreed with the trial court that the insurer had denied the short- and long-term disability insurance claimant’s applications wrongly and without the required substantial evidence to do so. Last year, we talked in this space...
LTD insurer may not arbitrarily discredit treating doctors’ opinions
On March 22, 2021, the U.S. District Court in the Western District of Washington ordered Prudential to pay long-term disability (LTD) benefits to the claimant, a software engineer who said he was unable to work based on mental impairments that developed after abusive...
Pre-existing condition and disability need substantial link to deny claim
Most disability insurance policies contain clauses that provide for the denial of disability claims for the first policy year if the disabling impairment was a pre-existing condition during a period of time immediately before the policy took effect – called the...
COVID-19 symptoms may form solid bases for disability insurance claims
While the medical community has communicated that many people who get COVID-19 either have no symptoms or a mild case, they have also advised that many experience severe symptoms, even if they do not require hospitalization. Additionally, an increasing number of...
Patterns in long-term care insurance denials, part 2
After paying the premiums for long-term care insurance coverage for years, it can be emotionally upsetting and financially devastating when the insurance company denies a claim for benefits. Unfortunately, this scenario is not uncommon. Long-Term Care insurers utilize...
Long-term disability claimant’s debilitating pain had subjective and objective support
The U.S. Court of Appeals for the Sixth Circuit recently held in favor of a long-term disability (LTD) claimant whose insurance company denied his claim based largely on severe, chronic back pain. Disability insurance companies often improperly discount credible...
Challenges of a disability insurance claim based on anxiety
We are currently having a collective experience that provokes some degree of natural anxiety in almost everyone. However, when the level of anxiety becomes overwhelming, it can prevent a person from being able to work in their occupation. Individuals with a private,...