Insurance companies that sell short- or long-term disability insurance policies are in business to make a profit. It follows that they are not necessarily there to be benevolent supporters of their policyholders when they struggle with disabling health conditions. To...
Insurance Company Tactics
Did your disability insurer weaponize an independent medical exam?
Most disability insurance policies allow the insurer to arrange for a reasonable, relevant independent medical examination (IME) of the claimant. While on its face this sounds fair and even potentially helpful for a disability claimant, the insurance company may use...
Disability insurers use aggressive surveillance to deny claims
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...
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...
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...
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...
Insurers use of drones in surveillance of disability claimants
When you are ill or injured to the point where you had to file a claim for disability benefits under your disability insurance policy, it can be disheartening to learn that during the initial review process or even while on claim that your insurance company put you...
Are you under surveillance by your disability insurance company?
Surveillance is a frequent tool used by disability insurance companies to try to deny or terminate claims. We often hear from claimants: "I have nothing to worry about, because I am actually disabled. Let them follow me;" "I would know if I were under surveillance;"...
Disability Insurance Company Claim Reviews – What Are They Looking For?
Throughout the time claimants are eligible for disability benefits and benefits are being paid, claimants are intermittently advised that their claim is being reviewed and that updated information is required. This often indicates that the insurance company is...