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Benefits – bennies – paid by your employer are hard to pass up, right? But, did you know that if your employer pays ANY of your disability policy premiums or you receive employer premium discounts, your policy can be converted into an ERISA case making it difficult, if not impossible to receive the benefits you deserve. Take the case of FRANK D’ELIA, M.D. v. UNUM LIFE INSURANCE COMPANY OF AMERICA, Civil Action No. 15-3040, Slip Copy (2016). Dr. D’Elia, a urologic surgeon, purchased five occupation-specific disability insurance policies through Unum Insurance Company’s Flexbill program through his employer, where he received a premium discount. Unum’s sales representative assured Dr. D’Elia that these policies would protect him should he become unable to…Read More
There is no easy answer to this question because disability insurance is as complicated as any other question where medicine and law converge. Only doctors, physical therapists, and other medical professionals are qualified to give a medical diagnosis to their patients. Likewise, only lawyers who practice disability law are qualified to determine whether a patient meets the legal requirements to receive disability insurance benefits. Why? To Borrow A Status Line From Facebook: It’s Complicated! Disability insurance laws represent a web of intricate legal definitions combined with individual circumstances reflecting the patient’s present and future physical or mental condition. Even within the disability insurance context, there are state laws that govern individual private disability insurance policies that differ from federal laws…Read More
Death due to coronavirus exposure would almost certainly not be covered under an accidental death insurance policy. BUT – and here’s the tricky part – there CAN BE an exception depending on how and when the virus was contracted. The leading case reaches back to 1931 in Chase v. Business Men’s Assurance Co, 51 F.2d 34 (10th Cir. 1931). The case involved an accidental death claim brought by the insurer’s beneficiary. The insurer contracted typhoid fever as a result of drinking contaminated water. The court determined the plain language of the policy “does not cover death resulting from typhoid fever not caused or brought about by accidental bodily injuries, unless it was intended that the word ‘disease’ should not include…Read More
It’s always gratifying when our clients receive the justice they deserve, like Lori. She’s a dental hygienist, who worked with our law firm and a new medical provider to win the benefits she deserved. Lori’s story starts like so many disability claims – with a denial. On a daily basis, Lori frequently stands, sits, lifts, stretches, grasps and handles dental equipment, and works overhead while performing her occupational duties. However, after suffering multiple injuries from two car accidents, Lori was unable to perform her hygienist duties. Initially, Lori’s Short-Term Disability claim was honored by Mutual of Omaha. But, one week before starting her Long-Term Disability, Lori’s benefits were cut off. It was at this critical juncture when Lori phoned our…Read More
Do you know a nurse like Karen Card? Karen is a nurse night shift supervisor who, no doubt, cared deeply for her sick patients…until she got sick and filed for disability. Karen is like any other medical professional among the 1.5 million Americans at-risk for losing their jobs and homes last year due to a medical crisis. In Karen’s case – Card v. Principal Life Insurance Company, 2019 WL 5618182 (6th Cir. Oct. 32, 2019) – it was the denial of her disability insurance claim for six years. This hardworking night nurse was diagnosed with Chronic Lymphocytic Leukemia in February 2013. Suffering from night sweats, exhaustion and fatigue, her health began declining. Over the next six months, Karen continued working…Read More
What gets me up early in the morning and keeps me at the office long after my husband, Cecil, expects me home for dinner, is the ultimate joy when our legal team scores a victory for our clients. Why? Because we know we’ve made a big difference in their lives. Take our recent battle – and win – for a local CT technologist suffering from Fibromyalgia and Chronic Fatigue whose insurance company denied her disability. We’ll call our client ‘Jane Doe’ because that’s the name lawyers call clients whose identity they want to protect. If you’ve ever had a CAT scan, you have met a ‘Jane Doe’. She’s the medical professional who calms your fears while positioning your body ‘just…Read More
Franklin first published it in 1748, and it’s as true today as it was hundreds of years ago, especially when it comes to filing your disability, life, or health insurance claim. Filing your claim or appeal too late can be the final blow for your case as the delicate balance between time and money can tip the scale of justice in the wrong direction, ultimately costing you the financial benefits you deserve as Emily Smith was soon to discover. In Smith v The Hartford, No. 4:20-CV-00041-CLM, 2020 WL 4815143 (N.D. Ala. Aug. 19, 2020), Emily Smith received disability benefits from Hartford Life and Accident Insurance Company due to depression, until her benefits were terminated by Hartford since depression benefits were…Read More
Alzheimer’s disease can seriously disrupt a person's life, causing progressive memory loss and mental impairments. If you are unable to work because of the disease or its complications, you may be able to receive long-term disability benefits. What Is Alzheimer's? Alzheimer's is a degenerative neurological condition. Usually the first symptoms include short-term memory loss, which worsens as the disease progresses. Changes in the brain eventually severely impact all aspects of a person's life — speech, behavior, problem solving ability, and even the ability to recognize family members or feed oneself. While Alzheimer's typically affects people who are already over the age of 65 and retired, it can appear in younger patients. This is known as early-onset Alzheimer's. While the disease can't be cured,…Read More
Disability insurance is an important part of any personal financial plan. It ensures that if you are injured or become too ill to work, your income will be at least partially replaced. Policy options vary, including the length of elimination period or the time you wait to collect. But what is an "own occupation disability" policy? If you're a high-income earner — such as a doctor, lawyer, or engineer — true own occupation disability insurance allows you to collect monthly disability benefits if you are unable to work at your chosen profession and allows you to work in a different occupation without losing disability benefits. Learn more about the types of policies below. Types of Own Occupation Disability Insurance There…Read More
When you purchase disability insurance, you expect coverage in the event an accident or an illness prevents you from working. Unfortunately, insurance companies like MassMutual employ a variety of tactics to collect premiums and avoid paying disability benefits. Unfair practices to delay payments or avoid paying claims are all too common. If you received a MassMutual long-term disability denial, you have the right to appeal the decision. How Do MassMutual Policies Work? MassMutual is a Fortune 500 company that sells a variety of insurance products. including life insurance, long-term care, and disability insurance. Like most disability insurance companies, MassMutual's disability policies are designed to pay a portion of your salary if you are disabled, usually between 45 and 60 percent. The length of time benefits are paid, or the benefit…Read More