If you are suffering from a disability and have had your benefits claim denied by your private disability insurer, then you may be entitled to bring an action against your insurer — whether your insurance coverage was purchased individually or provided as part of an employer-sponsored plan. Insurers are often quite aggressive in denying private disability benefits. In many cases, the insurer understands that if they deny a “difficult” or “ambiguous” benefits claim for which they can provide a reasonable justification, a number of claimants will simply refrain from any further attempts to secure their rightful benefits. This strategy saves […]
United States Magistrate Judge David E. Jones of the Eastern District of Wisconsin issued a Decision and Order on September 26, 2018 awarding disability benefits. Attorney of record for Plaintiff is Jennifer Danish. EDWARD PIOTROWSKI, Plaintiff, v. NANCY A. BERRYHILL, Deputy Comm’r of Operations, Soc. Sec. Admin., Defendant., 17-CV-1286, 2018 WL 4616457 (E.D. Wis. Sept. 26, 2018).
United States District Judge Sara Darrow of the Central District of Illinois, Urbana Division, issued an Order on September 21, 2018 granting Plaintiff’s Motion for Summary Judgment in so far as it sought a remand. Campbell v. Berryhill, No. 2:17-cv-02036-SLD-EIL (C.D. Ill. Sept. 21, 2018).
Insured Succeeds Against MetLife Even Under Arbitrary and Capricious Standard of Review in the Seventh CircuitOct 3, 2018 | Blog | Share
By: Stephen A. Jackson Hennen v. Metro. Life Ins. Co., 17-3080, 2018 WL 4376994 (7th Cir. Sept. 14, 2018). Hennen worked as a sales specialist for NCR when she sought treatment for a back injury. She was covered under her employer’s long-term disability plan insured by MetLife. When physical therapy and surgery failed to resolve her injury Hennen applied for LTD benefits under the plan. Acting as the administrator, MetLife agreed Hennen was disabled and paid benefits for two years. However, the plan had a two-year limit for neuromusculoskeletal disorders subject to several exceptions, one applies to radiculopathy. Hennen argued […]
For Court, Seeing is Believing (or not Believing): Video Surveillance and Credibility in Long-Term Disability ClaimsSep 6, 2018 | Blog | Share
By: Andrew B. Bryant The scenario is familiar: an insurance carrier denies a disability claim based, at least in part, on covert video surveillance of the claimant. A recent decision by the District Court of the Western District of Tennessee displays how video surveillance can be used by a Court not only as substantive evidence to evaluate degree of disability, but also as a n important tool in assessing the credibility of the entire claim. In the case, Plaintiff Gregory Eaton had been receiving Long-Term Disability (LTD) benefits from Defendant Reliance Standard Life Insurance Company due to a back condition […]
“Resolving Insurance Claim Disputes before Trial” published by the American Bar Association Tort Trial & Insurance Practice Section is available now. Jennifer Danish co-authored Chapter 7, Health and Disability Benefit or Insurance Claims, with JoAnn Dalrymple. The book can be ordered online at: https://shop.americanbar.org/eBus/Store/ProductDetails.aspx?productId=313723009
If you are the beneficiary of a life insurance policy — whether in Illinois or elsewhere — then you may find that the insurer unexpectedly denies your claim on the basis of an exclusion written into the policy (that you were not aware of). This can put you in a uniquely vulnerable position as a beneficiary. After all, if you were reliant on your loved one for resources, then the life insurance proceeds are critical to your ability to bounce back financially. Depending on the nature of the exclusion and the circumstances surrounding your loved one’s death, however, it is […]
In the private insurance context, the existence of a “waiting period” is to be expected, and in fact, waiting periods are nearly ubiquitous. Whether you are signed onto a health insurance policy, a disability insurance policy, or some other form of insurance, in all likelihood, there is a waiting period provision written into the insurance agreement. Insurers frequently use these waiting period provisions as the basis for a claim denial — even when the claim is otherwise legitimate. Fortunately, the waiting period restriction is not always applicable. Let’s take a brief look at some of the basics, first. Waiting Period […]
Accidents that give rise to disabilities — whether in the workplace or elsewhere — may seem complicated by the presence of multiple sources of compensation. If you have been injured in a motor vehicle accident, for example, then you may receive a substantial award of damages from the defendant, and you might also be eligible to receive disability benefits in accordance with your private disability insurance policy. In the state of Illinois (and elsewhere), however, these varied sources of compensation do not necessarily interfere with one another, except in limited circumstances. Private Disability Benefits Are Not Affected Private disability insurance […]
In the private disability insurance context — in Illinois and elsewhere — insurers will often deny legitimate disability claims on the basis that the policyholder’s condition is not actually disabling in accordance with the language of the insurance plan. There are no absolute rules that apply to all disability insurance policies — the definition of disability may differ significantly depending on policy. Generally speaking, plans with high premiums have broader definitions of disability than cheaper plans. For example, your plan may include a broad definition of disability that awards disability benefits in the event that your condition renders you incapable […]