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Over Two Decades Of Holding Insurance Companies Accountable

San Francisco Law Blog

The basics of bad faith

When you enter into a contractual relationship with an insurance company, you expect that they will honor the terms contained in their policy. At the time you decide to accept their offer for coverage, they made promises to you that you would be protected in the event that something should happen.

Unfortunately, in many circumstances, insurance companies in a host of different industries often deny valid claims made by policyholders. They are hoping that you accept their answer of no and move on, without challenging them on their response.

What happens with long-term disability claims?

Many of us depend upon our jobs to provide us with the means to make a living. We create budgets and financial plans based upon the amount of money that we make each month. When we suffer an injury or illness that makes working impossible, we need to know what we can do to get the compensation we need in order to make ends meet.

If you suffer an injury or illness that is not workplace related, you will have to depend on your long-term disability insurance coverage in order to get benefits. You may purchase such insurance independently, or, you may have a plan that is provided by your employer. Depending upon the type of plan you have, different rules may apply to how the plan is carried out and how it may impact your situation.

Answers to your questions about long-term disability

Many clients come to us and have serious questions when they suffer from a disability that makes them unable to work. They have disability insurance, but do not know what that means or what that entitles them to receive from their insurers. In this post, we want to answer some of the most common questions that we get about long-term disability insurance.

 

What is long-term disability insurance?

We depend upon our jobs to provide us with the income to make ends meet. We may be the only ones who can perform certain tasks at the workplace. If we suffer an injury or illness that makes it impossible to perform these tasks, we could see a substantial loss of income due to our inability to work.

Long-term disability (LTD) insurance helps us recover compensation in order to make ends meet. These payments may exist for a limited period of time, or may run for the rest of our working lives. It all depends upon the type of coverage that we have from our employers or purchase from an insurer. In this post, we explain some basic information about LTD insurance, and what you should know if you run into problems with your policy.

9th Circuit case considers disability benefits

Recently, the 9th Circuit Court of Appeals released a decision that may have a significant impact upon long-term disability insurance matters in California. The ruling could potentially limit some of the power that insurance companies have to deny claims for benefits.

The case concerned a woman who worked for Boeing. As a benefit of employment, the employee was covered by a health and wellness plan provided to those who worked for the company. The plan had a clause that allowed Aetna, the insurance company that handled the health and wellness plan, substantial discretion when deciding whether or not an individual qualified as disabled.

What are the main conditions that lead to long-term disabilities?

Many workers suffer from injuries and illnesses that make it difficult for them to work. When these conditions result in an extensive leave of absence, the workers will need to find a way to make ends meet. Some of these individuals will have long-term disability insurance coverage, and will file a claim for benefits in order to be able to withstand the financial impact of missing time from work.

In this post, we wish to discuss some of the most common causes of disabilities, as well as the options available if an insurance company denies a request for coverage under a long-term disability insurance policy. This will help provide you with some basic information about the steps that you can take if your insurance company is not playing by the rules.

Understanding what happens when long-term disability insurance benefits denied

Many people purchase long-term disability insurance coverage. This insurance provides them with compensation in the event that they suffer a serious injury or illness that requires them to miss extensive time from work.

There are several advantages to having a long-term disability insurance policy, including the peace of mind of knowing that you will have the ability to make ends meet while dealing with your serious condition. Unfortunately, many of the companies that provide this coverage often make it extremely difficult for people to obtain the benefits according to the terms outlined in the policy. 

Changes coming for ERISA disability claims?

New regulations will now govern the ERISA disability claims and their appeals proceedings. These regulations will take effect on all disability claims that will be filed in 2018 - starting from the very first day of January.

The new rule will affect all disability plans under ERISA. These include pension plans and all long-term and short-term plans whose benefits are hinged on whether the claimant is disabled. The following are the major changes that will govern the ERISA disability claims process. 

Know the traps of ERISA

The Employee Retirement Income Security Act (ERISA) has been a headache for many people who have been hurt on the job since it was passed by U.S. Congress in 1974. Before the law was passed, many employees would try to file long-term disability claims from companies who promised them rock solid insurance policies and benefits, only to find out the company that owed them money was bankrupt or out of business. 

Lifetime Disability Benefits

Some insurance companies offer lifetime disability benefits.  They usually come at an additional fee (or premium) and are attached to the policy as an "endorsement" or "rider" to the policy.  But not all lifetime coverage is created equal.  Some policies - usually those that were issued in the 1980's or 1990's - merely continue your benefits for life without any restrictions or limitations.  Benefits under these policies can even increase over time pursuant to a Cost of Living Adjustment (COLA) provision.  These policies offer the broadest possible coverage.  Other policies are not so generous.  Their coverage may be contingent on when you become disabled or the type of disability that you are suffering from.  For instance, some policies provide reduced benefits if you are disabled after age 60.  Others provide for reduced benefits if you are disabled as a result of a sickness rather than an injury.  The point: it pays to read your policy and know your rights.   

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