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February 2016 Archives

New Law about Reimbursement of Money to Insurer

In a recent Supreme Court Case, Montanile v. Board of Trustees of the Nat. Elevator Industry, the Supreme Court held that "Other Income" benefits (Social Security disability benefits, workers compensation awards, personal injury settlements) paid to a claimant by a third party for a related claim may not be recoverable by an insurance company or plan administrator in certain circumstances. This is interesting as it may impact a disability insurance company or plan administrator's right to seek reimbursement for third party benefits paid to a claimant in the past. More specifically, many disability plans appear to give the claim administrator the unrestricted right to seek repayment for third party benefits, i.e. "Other Income benefits," obtained by the claimant while on claim or eligible for disability benefits. In Montanile, the Supreme Court found that there are instances in which the claim administrator can no longer unequivocally demand repayment of such benefits.

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