12 February

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Five Things Every Long Term Disability Policy Holder Should Know About Submitting a Notice of Claim

Submitting a Notice of Claim Long Term Disability

Long term disability carriers don’t make it easy for policyholders to get the disability benefits they deserve. Unfortunately, you can make crucial mistakes from the very beginning of your claim including how and when you submit a notice of claim. Before you “give notice” to the disability insurance company, you should do the following: (1) first, determine whether you have a claim, (2) whether your medical records support your claim, and (3) pick the right day to stop working. Only when you have done those things should you, or better yet, your attorney send the disability carrier (4) your notice that you will be filing a disability...

30 January

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Substance Abuse Limitations and United of Omaha Disability Insurance

Posted by Nancy Cavey

in United of Omaha

Substance Abuse United of Omaha Disability Insurance

Many disability policies will have a 24-month payment limitations for disabilities due to “substance abuse” and it is not uncommon for disability carriers to argue that, notwithstanding physical problems, a policyholder is really disabled because of drug use. In the case of Blount v. United of Omaha Life Ins. Co., No. 16-3672,-F.App’x, 2007 W.L. 2829102 (6th Circuit, June 30, 2017), Ms. Blount, a former hospital controller began receiving long term disability benefits after leaving work in March of 2008. She was paid benefits for seven years as a result of undifferentiated connective tissue disorder. She also suffered from depression and anxiety...

29 January

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How The Date of Termination and The End of Disability Coverage Can Destroy a Long Term Disability Claim

Posted by Nancy Cavey

in Long Term Disability

Date of Termination End of Disability Coverage Long Term Disability

In Boothe v. Deseret Mutual Benefit Administrators, No. 1:16-cv-0008-DN, 2017 W.L. 2787748 (D. Utah June 27, 2017) the Court found that because the disability coverage ended on November 2, 2012, when the employee's employment was terminated the claim for disability benefits was correctly denied. Termination Means The End Of Coverage Boothe had been injured in a motor vehicle accident and returned to work with accommodations, four-day work week with one day in the office and three days at home. Her employment ended on November 9, 2012, and she completed an application for disability benefits on December 29, 2012. Boothe’s medical records did not...

09 January

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Reliance’s Structural Conflict of Interest Results In Reversal of District Court Order

Posted by Nancy Cavey

in Reliance Insurance Company, Short Term Disability

It’s not uncommon for disability insurance companies, like Reliance, to be responsible for both paying benefits and administrator during the claims process. That’s a conflict! Disability carriers routinely have provisions in the policy that provides them with the discretion to interpret the terms of the policy and make a determination of entitlement to benefits. To overcome that denial, the policy holder has to show an abuse of discretion. The Abuse of Discretion Standard While the fact that disability insurance companies, like Reliance, are responsible for paying benefits and administering the claims process, it won’t alter the standard of review. However, depending on what...

28 December

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Worker’s Compensation Insurance Rates Are On The Decline!

Posted by Nancy Cavey

in Workers Compensation

workers comp insurance claim rates Florida

Did you know that Worker’s Compensation insurance renewal rates across the United States have been in decline for over 17 quarters? According to an article by Jim Thompson published in the Worker’s Compensation Institute, entitled Worldwide: Worker’s Comp Insurance Rates on the Decline, not only has there been a worldwide decline in renewal rates across all lines or property, casualty and professional insurance products, this has been going on for over 17 quarters or some 3 years! It’s been suggested that the decline in worker’s comp provider rates is a result of a “feeding frenzy” among insurers in the worker’s compensation...

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