On January 21, an Alabama federal court decided that the proper standard of judicial review in an appeal of a long-term disability insurance benefit termination was “de novo” review. In an appeal of a federal disability insurance denial or termination, the court must...
HELPING PEOPLE LIKE YOU WITH THEIR DISABILITY, LIFE AND LONG-TERM CARE BENEFIT CLAIMS
Denied ERISA Claims
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...
Dealing with a disability insurance claim denial
When a Florida resident gets seriously injured or sick and needs to file a claim on their disability insurance, they could be faced with an unexpected denial of benefits. Many group and other employer insurance plans are covered under ERISA, the federal Employment...
Important Tips for Appealing an ERISA Disability Insurance Denial
A denial of disability insurance benefits too often comes as a surprise to individuals who file legitimate claims and are genuinely unable to competently perform their job duties with reasonable continuity. Making the decision to apply for disability insurance...
MetLife was unreasonable to reduce insured’s disability benefit by pension funds rolled over into IRA
By Maggie Smith of :In a decision last month out of the Fifth Circuit Court of Appeals, the Court found Metropolitan Life Insurance Company ("MetLife") was unreasonable to reduce Mr. Thomason's long-term disability benefits by pension funds...
Cigna Agrees To Reevaluate And Settle Improperly Denied Disability Claims And Terminated Disability Payments
In response to an investigation into the unfair claims handling practices of CIGNA since 2006, the CIGNA Group has agreed to set aside $77 million to settle claims that it improperly denied long term disability claims and wrongly terminated disability benefit...