Over the next few weeks, we will be discussing the five ways that the new claim procedure regulations will impact your long-term disability claim. For claims filed after April 1, 2018, some changes have been made that could be helpful to claimants and will hopefully make the claim process fairer. Change #1: Courts Can Use de novo Review The new regulations permit the court to use the de novo review in cases where an insurer failed to strictly adhere to the regulations. This L
Many experienced litigators have gotten caught in the speed trap known as ERISA. As with any other speed trap, ERISA has some unexpected provisions that can catch even the experienced litigator off guard. Just as "Police Jurisdiction" signs can provide some warning when travelling unfamiliar roads, litigators should be on the lookout for ERISA's unique provisions. The issue of jurisdiction versus venue is just one of these “gotcha” provisions.
Many people may not understand
In the world of long term disability insurance carriers, managers of claims departments are constantly looking for a way to make the company more profitable. One way is to push the boundaries regarding offsets written in the plan. What is an offset? An offset is the reduction of the long-term disability benefit due to be paid by the receipt (or the right to receive) monies from another source. A very common offset in nearly all group long term disability plans is the Social S
Some people honestly believe that if they are transparent and honest, their long-term disability adjustor will pay their claim. Unfortunately, that is usually not the case. Following are actual examples of things we have heard clients say to their adjustors, few ended up actually derailing their claim. It is good to be transparent and honest with your ERISA attorney but not necessarily with your long-term disability adjustor. Here are 10 things NOT to tell your long-term disa
Alice in Wonderland – “I give myself very good advice, but I very seldom follow it.”
In a recent ERISA case, Magistrate Judge David Baker explained that if an insurer uses a doctor to deny a claim, it has to also follow the doctor’s advice. (See Schultz v. Aetna life Ins. Co. et al, 2017 WL 4803806 (M.D. Ala. 2017). Should be common sense, right? Except this is ERISA, also known as Wonderland where things can sometimes get “curiouser and curiouser.”
Overview of Case Sch
They were both in a recent case opinion written by Magistrate Judge Jonathan Goodman in Johnston v. Aetna Life Ins. Co., 2017 WL 4654431(M.D. Fla. 2017). Judge Goodman pulled lyrics from No Doubt’s song “Don’t Speak” to illustrate the Plaintiff’s case wherein he was seeking an explanation as to exactly why his claim for long term disability benefits has been rejected. “In their song ‘Don’t Speak,’ the rock band No Doubt sang the following lament about being rejected: ‘Don’t s
Though most attorneys have to attend law school and pass the Bar exam to practice law, Reliance Standard Insurance Company decided that the ability to walk a dog was sufficient enough for one attorney to practice law.
In a recent case, an attorney who suffered from numerous debilitating medicial conditions, including osteoarthritis and severe fibromyalgia, struggled with her health until eventually she had to cease practicing law. She became unable to meet with clients, con
Long term disability insurance can be a lifesaver for the American worker. When they find themselves too ill or injured to work, they can rely on monthly payments to replace their income so they can continue to take care of their family. These monthly payments may be scheduled to last for a certain period of time or for the rest of their lives, depending on the policy. Sometimes, though, instead of a monthly payment the worker may be offered a lump sum payout on their settlem
Remember the Capital One® commercial, “What’s in Your Wallet?” It is also important to know what is in your disability plan, since it will affect your wallet. Many of us never think we will be unable to work. However, every day we are only one accident away from that. If you have a plan, you need to know what is in it. If you don’t have one, you are risking more than you may realize. The Middle District of Florida recently was looking at a plan – a FedEx plan. We have previou
Not all disability benefits programs are created equal. While some programs share similar features, there are key differences that you need to be aware of. Failing to understand the types of benefits available, particularly when disability is involved, can lead to frustrating complications. The similarities between long-term disability insurance and Social Security Disability Insurance often cause confusion. Acquisition Long-Term Disability (LTD) Insurance. As its name states
Navigating through the sometimes complex legal system can be difficult for even the most seasoned and knowledgeable person. When it comes to an issue as important as settling a long-term disability claim, there isn’t much room for mistakes. An experienced and knowledgeable attorney can work for you to ensure that the process goes smoothly and that you receive all of the benefits to which you are entitled. How Do I Choose the Right Attorney? Even a brief online search will rev
If you have ever heard legal terms tossed around during a conversation about long-term disability and were left scratching your head, don’t worry, you aren’t alone. Like any specialized field, the nomenclature of disability law can be a mystery to those who don’t navigate it on a daily basis. With a little bit of guidance, however, things that were once foggy will become clear. That is why we have put together a brief overview of some of the terms commonly associated with lon