Court Directs Insurer to Take Fresh Look at Coverage Denial
Denials of health insurance coverage for treatment of behavioral health conditions have been drawing increasing judicial attention. […]
Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
The Evolution of Litigation of Health Insurance Claims Involving Mental Health
A lengthy history of discrimination by health insurers against claims involving behavioral health conditions and substance use disorders led Congress to pass the Mental Health Parity and Addiction Equity Act3 (MHPAEA) in 2008. 4[…]
Navigating Disability Insurance Claims for Head Injuries and Post-Concussion Syndrome
When one thinks of disabling medical conditions, they usually imagine a number of physical diagnoses. […]
Hughes v. Northwestern University – The Seventh Circuit Upholds Plaintiffs’ Excessive Fee Claims
The Employee Retirement Income Security Act of 1974 (ERISA)1 governs both retirement and welfare benefits2 (i.e., health, life, and disability benefits) provided by employers to their employees. […]
Can You Work and Be Disabled at the Same Time?
Can you work and qualify for disability insurance benefits at the same time? […]
How to Respond to New Evidence Generated After Submitting an LTD Appeal
Proton beam radiation therapy is used to treat various forms of cancer. Rather than using X-rays, proton therapy directs focused energy from protons at tumors. […]
6th Circ. Judge Correctly ID’d ERISA Civil Procedure Conflict
A recently issued ruling from the U.S. Court of Appeals for the Sixth Circuit, Tranbarger v. Lincoln Life & Annuity Co., addresses the fundamental issue of how courts should be adjudicating Employee Retirement Income Security Act cases.[…]
ERISA Ruling Shows Why Insurers Must Justify Claim Denials
Employee benefit claimants’ entitlement to a full and fair review of claim denials prior to judicial intervention is embedded in the Employee Retirement Income Security Act.[1] Regulations promulgated by the
U.S. Department of Labor flesh out the specifics as to what constitutes such a review. […]
Updated Standard of Care Cements Ruling in Health Benefits Dispute
Proton beam radiation therapy is used to treat various forms of cancer. Rather than using X-rays, proton therapy directs focused energy from protons at tumors. […]
How to Defeat Ambiguities in Disability Insurance Claim Forms
The start of every disability insurance claim is the completion of forms the claimants is required to submit to receive benefits. While the forms are ostensibly designed to be clear and straightforward, the questions asked on the disability insurance claim forms often confuse claimants, and ambiguities in disability insurance claim forms can lead to misunderstandings and delays in the processing of claims. […]
Digestive Disorders and Disability Insurance: What You Need to Know
Many physical and mental conditions can prevent an individual from working on a regular basis. That is particularly true of a number of digestive disorders. If you suffer from a digestive disorder and plan to file a disability claim, it’s important that you be aware of how insurance carriers address these types of claims. […]
Disability Insurer Loses Bid to Limit Benefits Physician Sought
Both federal and state laws mandate parity in health insurance policies between physical and behavioral health conditions. However, mental health parity is not required in disability insurance policies by any state other than Vermont. […]