Can disability be proven by pain symptoms alone or is “objective” medical evidence required? A recent federal court ruling from Maryland, Krysztofiak v. Boston Mutual Life Insurance Co., 2019 WL 6528609 (D. Md., Dec. 4, 2019), offers instructive guidance in answering that question. In the Maryland case, Dana Krysztofiak, a registered nurse, had to quit […]
A decision by the U.S. Court of Appeals for the Ninth Circuit questions an insurer’s behavioral health treatment guidelines.
According to the Centers for Disease Control and Prevention, accidents are the fifth leading cause of death in the United States. Will your loved ones be financially protected should you succumb to an untimely death due to an accident? Accidental death and dismemberment insurance (AD&D) may be purchased in addition to traditional life insurance or offered by […]
If you lose your health insurance as the result of job loss (resignation or termination), divorce, death of a spouse, or other qualifying event, the Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”) can provide a welcome bridge while you work to secure new health coverage. Yet there are many complexities and pitfalls to COBRA […]
If a disability, health or life insurance claim is denied, gathering information, staying within deadlines and communicating with all relevant parties to gather necessary information is essential in order to overturn the decision. When a dispute over any insurance benefits arises, being told “no” is not the final word. If the coverage at issue is […]
Whether you’re still receiving long term disability benefits or are in the midst of an appeal, it is always a best practice to make sure the insurance company has all evidence that supports your claim. This includes evidence from your Social Security disability claim file. Overview Once you are approved for long-term disability benefits, your […]
What is a crime? Because accidental death policies exclude coverage if death occurs in the course of a commission of a crime, the question can be challenging as a recent decision by the 10th U.S. Circuit Court of Appeals illustrates. The ruling in Caldwell v Unum Life Insurance Company of America, 2019 WL 4463495 (10th […]
The subject of pre-emption under the Employee Retirement Income Security Act is challenging, as illustrated by multiple Supreme Court rulings that have attempted to address pre-emption issues. The general rule is that any state law which relates to employee benefit plans is pre-empted if the law conflicts with the administration of an ERISA claim. However, […]
Obtaining disability insurance is tricky. If you are purchasing coverage to supplement employer-supplied insurance or seeking insurance because you have no other coverage, there are a lot of variables to consider. It’s a sad fact, but many Americans give little thought to disability insurance coverage until it is needed. Understanding the following information will strengthen […]
The absence of medical treatment during a doctor’s visit does not necessarily mean a claimant is ineligible for benefits.
An inadvertent ambiguity in an insurance policy can be costly as Federal Insurance Co. learned in Tyll v. Stanley Black & Decker Life Insurance Program, 2019 WL 3081061 (D. Conn. July 12, 2019). There, the court resolved a motion for summary judgment seeking a determination as to the amount of business travel accident insurance owed […]
If your long-term disability claim has been denied, you should not take “no” as the insurance company’s final answer. In most circumstances, you have the right to submit an appeal challenging the benefit denial; and if the appeal is unsuccessful, a wrongfully denied claim may be litigated in court. What most people don’t realize, though, […]