We spend a lot of time on this blog discussing the dubious, sometimes nefarious tactics insurance companies will use to deny or terminate long-term disability benefits, especially those claims covered by ERISA. Although every claimant has a right to sue the insurance...
ERISA
Navigating the ERISA appeals process for long-term disability claims
An unfortunate fact in the ERISA long-term disability world is that many people will find themselves appealing decisions which deny or terminate benefits. Whether the insurance company denied your initial application, or your benefits were cancelled later, you must...
Judge tosses claim denial for provider’s catch-22 logic
Anyone familiar with the sometimes inexplicable state of disability insurance claim denials won't be shocked by a recent case where an insurer's arbitrary machinations ended in a swift summary judgment. A seemingly unremarkable benefits application In Mucciacciaro v....
Health insurance claim denials are getting more brazen
Most people over 40 remember a time when health insurance was simple. We paid our monthly premiums and received coverage for almost every doctor visit and procedure that wasn’t obviously elective. Today, that arrangement is but a happy memory of a simpler time. The...
Courts find fault with 6 in every 10 Social Security denials
If you’ve been struggling with a baseless, inexplicable Social Security disability claim rejection in recent years, you’re not alone. The highest rate of Social Security Disability Insurance (SSDI) claim rejections in years is gumming up courtrooms nationwide. Citing...
Even an ERISA courtroom win can be a bureaucratic nightmare
ERISA disputes are perhaps the worst-timed legal challenges a person can encounter. People with incapacitating illnesses or injuries, often involving a cognitive impairment, must become proficient in legal jargon and the convoluted world of long-term insurance...
Long COVID highlights the ongoing flaws of disability programs
Congress recently voted to end the COVID public health emergency that has been in place for the past three years. While it may seem as if day-to-day life has essentially returned to normal, hundreds of Americans continue to die of COVID complications each week, and...
Be careful what you sign during an ongoing ERISA appeal
In theory, we should never sign anything without reading and understanding its contents. In practice, we are presented with sprawling documents and agreements stuffed with legal jargon that can baffle the best of us on at least a weekly basis. Our instinct is to sign...
Old ERISA benefits cancellation tricks never die
Though the judgment against the insurer was swift, a recent ERISA case is a timely reminder that sometimes insurers will resort to the benefits cancellation equivalent of throwing pasta at a wall, hoping something will stick. In Caudill v. The Hartford Life &...
The distinction between ‘illness and ‘injury’ in ERISA claims
A recent successful appeal highlighted how the sometimes everyday interchangeability of the words “illness” and “injury” can mean the difference between temporary and lifetime ERISA benefits. The thrill of temporary victory In Stein v. Paul Revere Life Ins. Co., the...