Ensure Future Financial Security With Life and Accidental Death Insurance Policies
Life and accidental death insurance policies can be an important part of an individual’s financial planning to provide security for their families.
Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
How to Challenge a Disability Insurance Denial?
The rationale behind the purchase of disability insurance is to provide an economic safeguard against unforeseen sickness or accidental injury. When misfortune occurs, economic hardship results. And if benefits are denied without justification, the premiums invested in insurance coverage appear worthless. All is not lost, though, because there are ways to fight back. Step 1: […]
Deficient Vocational Review Leads to Remand
DeBofsky Law won a victory in the U.S. Court of Appeals for the Seventh Circuit in a case entitled Lacko v. United of Omaha Life Ins. Co., 2019 WL 2439786 (7th Cir. June 12, 2019). The plaintiff, Shirley Lacko, stopped working as a senior auditing manager for an accounting firm when the effects of multiple chronic impairments […]
“Substantial Compliance” Not a Valid Excuse for Tardiness
Claim regulations in the Employee Retirement Income Security Act impose deadlines on claimants and plan administrators to submit claims and render claim decisions. Strict deadlines also apply to claim appeals. Claimants are allowed up to 180 days to submit appeals from denials of disability benefit claims, and if a claimant submits an appeal even a […]
Federal Judge Found Insurance Giant Breached Its ERISA Fiduciary Duties and Violated Illinois Law
Approximately 50 percent of Americans receive health insurance through their employer,1 making most of those plans subject to The Employee Retirement Income Security Act of 1974 (“ERJSA”). After passage of the Mental Health Parity and Addiction Equity Act of2008 (“MHPAEA”), the majority of health plans that cover mental health treatment, including large employer -sponsored plans, […]
A Primer on Behavioral Health Residential Treatment Cases
Our firm recently won the case of Dominic W v. Northern Trust Co. Employee Welfare Benefit Plan, 2019 WL 2576558 (N.D. Ill. June 24, 2019), which took a health benefit plan to task for denying residential treatment behavioral health claim.
Ruling Holds Cause of Disability Not Necessary to Claim Benefits
Does a claimant seeking disability need to prove the cause of disability to qualify for benefits? According to a recent federal decision from Georgia, the answer is no. Arthur Lesser IV, the plaintiff in Lesser v. Reliance Standard Life Insurance Co., 2019 WL 2416926 (N.D. Ga. June 4, 2019), worked as a software engineer for […]
Credibility Important Element When Seeking Disability Claim
The outcome of many disability insurance cases depends on the court’s assessment of the claimant’s credibility since symptom complaints are difficult to objectively verify. A ruling from a federal court in New York offers an excellent example. The case of Khan v. Provident Life and Accident Insurance Co., 2019 WL 1970516 (W.D. N.Y., May 3, 2019), involved Dr. Farooq Khan, a neurologist, who complained of joint pain and fatigue that worsened over several years, although an exact diagnosis was elusive.
Returning to Work Post-Injury Doesn’t Invalidate Disability Claim
Does working after suffering an injury invalidate a subsequent disability insurance claim? According to a recent U.S. District Court ruling from Florida, the answer is no. In Kaviani v. Reliance Standard Life Insurance Co., 2019 WL 1759245 (M.D. Fla., March 27, 2019), Kia Kaviani, a dentist, sustained neck injuries in a car accident in 2012. […]
What Is the Meaning of “Regular Occupation” in a Disability Insurance Policy?
Most people assume that if they become unable to perform their usual work on account of sickness or injury, that they would qualify to receive benefits under their work-sponsored long-term disability insurance coverage. That may not be the case, though. In Nichols v. Reliance Standard Life Ins. Co., 2019 WL 2223614 (5th Cir. May 23, […]
Is Death Resulting From Autoerotic Asphyxiation a Self-Inflicted Injury?
Is death resulting from autoerotic asphyxiation gone wrong an accident or is coverage under an accidental death insurance policy precluded by the policy’s “self-inflicted injury” exclusion. A recent appellate court ruling overturned a lower court’s determination that the language of the exclusion is ambiguous and therefore had to be resolved in favor of the insured […]
Social Media No Substitute for Sound Medical Records
When used appropriately, social media may sometimes prove to be a valuable tool to investigate personal injury and disability insurance claims. However, when an insurer improperly denies a claim for benefits based on an unjustified reliance on social media postings, the claimant may be able to turn the tables on the insurance company. In Williamson […]