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Over Two Decades Of Holding Insurance Companies Accountable

October 2016 Archives

Tips for Attending an Insurance Company's "Independent" Medical Examination

If you find yourself unable to work due to an injury or illness, the last thought on your mind is submitting to an insurance company's demand to be examined by a doctor you've never met.  Insurers refer to these events as "Independent Medical Examinations," although under the circumstances they are anything but independent.  The "independent" doctor is selected by the insurer, derives income directly from the insurer, and depends on the insurer for future business.

All disability policies are not created equal

Most of us are covered by disability policies through our employers.  Premiums are paid by payroll deductions and coverage is described in a summary plan description.  Those policies (subject to a few exceptions discussed below), are governed by federal law, specifically, the Employee Retirement Income Security Act of 1974 ("ERISA").  These laws provide strict requirements for appealing a claim denial, as well as limited remedies for those whose disability benefits are wrongfully cutoff by their insurance carrier.  No matter how misguided an insurer's decision is, the only remedy for insureds under ERISA is (1) the payment of past disability benefits owed by the carrier and (2) the possible recovery of attorneys' fees.  In most circumstances, nothing else is recoverable. 

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