In Illinois, policyholders may have their otherwise legitimate disability claims denied if they fail to exercise reasonable efforts in recovering from their disability (and otherwise mitigating their losses). As a general rule, policyholders must uphold their end of the contractual bargain, so to speak — the insurer is not an absolute guarantor of losses suffered by the policyholder. The insurer can only be held reasonable losses that arise due to the disabling condition at-issue. Confused? Let’s take a quick look at the duty to mitigate imposed on disability policyholders in Illinois. The General Duty to Mitigate Throughout the country, insurance […]
By: Jennifer Danish Courts infrequently award attorneys’ fees to defendants for having to defend themselves in ERISA disability benefit claims. Recently though, the Court, in James W. Hackney v. Allmed Healthcare Management, Inc., No. 3:15-CV-00075-GFVT, 2018 WL 1981902 (E.D. Ky. Apr. 27, 2018) ordered an unsuccessful plaintiff to pay the defendant attorneys’ fees and costs, because the plaintiff pursued a cause of action not generally recognized as available under ERISA. Hackney brought a state law negligence claim against Allmed for rendering an unlicensed medical opinion about him in connection with his long-term disability benefit claim under an ERISA-governed benefit plan […]
As a general rule, insurers do everything possible to minimize their liabilities. In the disability insurance context, this may involve the denial of an otherwise legitimate benefits claim on the basis of an exclusion written into the insurance policy. Exclusions are often written in a particularly ambiguous way, however, so as to encourage prospective policyholders to enter the insurance agreement — the policyholder may interpret the exclusion in a broad and more favorable manner, when the insurer actually intends to interpret the exclusion more strictly. Once you have become disabled, the insurer’s interpretation of the exclusion may come as something […]
Andrew Bryant & Jennifer Danish On April 4, 2018, the Seventh Circuit Court of Appeals issued an opinion vacating the denial of a Supplemental Security Income disability claim brought by 47-year-old Rebecca Ann Akin, who suffered from fibromyalgia, back and neck pain, and headaches. Akin v. Berryhill, 887 F.3d 314 (7th Cir. 2018). On appeal, Akin argued that the administrative law judge wrongly discounted her allegations of back pain, improperly credited the opinions of agency doctors who had not reviewed all the medical records (including MRI scans) and disregarded her history of headaches. In its opinion, the Seventh Circuit described […]
Roy Alan Cohen, The Tort Trial and Insurance Practice (TIPS) Section 2018-2019 Chair, appointed Jennifer Danish to serve as a Immediate Past Chair of the Health and Disability Insurance Law General Committee for 2018-2019 on April 25, 2018. Jennifer has served as the Chair of the Committee 2017-2018 and has accepted the appointment. Mr. Cohen also appointed Jennifer to serve as a Member of the Solo and Small Firm Task Force, the Diversity and Inclusion Standing Committee, and the Plaintiffs Practice Standing Committee for 2018-2019 on April 26, 2018. These leadership appointments are a clear recognition of her competence and experience, commitment to TIPS, and […]
James F. McCluskey, ISBA President-Elect, appointed Jennifer Danish to serve as a Member of the ISBA Standing Committee on Law Office Management & Economics for 2018-2019 on April 24, 2018. Jennifer has accepted the appointment and is honored to serve in the coming year.
James F. McCluskey, ISBA President-Elect, appointed Jennifer Danish to serve as a Member of the ISBA Standing Committee on Disability Law for 2018-2019 on April 24, 2018. Jennifer has accepted the appointment and is honored to serve in the coming year.
James F. McCluskey, ISBA President-Elect, appointed David A. Bryant to serve as a Member of the ISBA Insurance Law Section Council for 2018-2019 on April 24, 2018. David has accepted the appointment and is honored to serve in the coming year.
In Illinois, and throughout the country, the nature of the insurance business — whether in the health insurance, property insurance, business liability insurance, or disability insurance contexts — is to sign on policyholders while limiting the payout amount in a potentially covered event. Considered from the perspective of the insurance company, success is being able to deny coverage for a legitimate claim, or perhaps delaying the processing of the claim to such an extent that the policyholder simply withdraws from any further attempt at recovering their rightful benefits. State and federal law grants policyholders a number of rights, however, centered […]
As a long-term disability (LTD) insurance policyholder, you may find yourself in a particularly vulnerable position. Despite the fact that you have been rendered disabled, your insurer may delay, undervalue, or deny your legitimate claim for long term disability benefits. Insurers are always on the lookout for opportunities to minimize their various liabilities. If you are receiving supplemental income, your insurer may see it as an opportunity to avoid having to pay out benefits. Fortunately, in most cases, you are entitled to received LTD benefits even if you are receiving supplemental income from various sources. You may even be entitled […]