San Francisco Insurance Law Blog

You're not powerless against your insurance company

You trusted your insurance company. You made those monthly payments because you believed that they would be there for you when you needed them. Then you filed a valid claim, and they denied it.

You can't believe it. You feel like they robbed you, essentially. They took your money and then refused to honor the obligations that came along with that money.

What law can help protect my retirement plan?

As an employee of any age, you should be thinking about how your employer is contributing to your retirement plan. This is something that younger generations tend not to concern themselves with. However, many people approaching retirement begin to realize that they should have placed more importance on it throughout the entire duration of their careers.

You may be wondering if there are any laws and regulations in place to ensure that employers invest in and protect their employees' retirement plans. One such law is the Employee Retirement Income Security Act (ERISA). This act was put into place in 1974 to protect employees.

Tricks of the disability insurance trade: Deny until death

What's one sure-fire way insurance companies can avoid paying out a long-term disability claim? When the policy holder dies before he or she can collect.

That seems rather obvious and makes sense -- until you realize that some long-term insurance companies will frequently find ways to delay payment on a long-term disability policy as long as possible, basically hoping that the insured will either give up or die.

Can you protect yourself from a faulty insurance policy?

Having an adequate insurance policy is something that can provide you with more confidence and put your mind at ease because you can secure some form of support and protection in case you are involved in certain accidents. However, if you are struggling with getting the full benefits out of your insurance policy in California because they are refusing to honor the terms of your agreement, you could be facing a difficult battle. 

Familiarizing yourself with the terms and conditions of your insurance policy is central to your ability to know under what conditions it will function. If you have holes in your coverage and are unable to find a customized plan that is adequate for your lifestyle and the unique risks you face, you may wish to look into alternative policies that can provide supplemental protection and give you the peace of mind you need. 

Can work incidents result in long-term disability?

California residents who get involved in work-related incidents can end up with injuries that result in short or long-term disability. In these cases, Pillsbury & Coleman, LLP, are here to help you deal with the insurance situation.

“Work-related incidents” is a term that covers a very large scope of possible happenings which often result in injury to you and other employees. It can cover everything from factory explosions to repetitive stress injuries received from typing too much without getting enough of a break.

Private disability or ERISA? The best policy is both policies.

By Terry Coleman

In years past, professionals who wanted a long-term disability policy would go out in the private market. These policies would protect them if they became unable to practice due to injury or illness. And if that doctor or other professional changed jobs, the coverage would follow them.

Why is my insurer demanding an independent medical exam?

One of the most common questions we get is about independent medical examinations. You are limping along (perhaps literally) on disability, and out of the blue the insurance company wants proof that you are still disabled.

This is disheartening and scary. An unfavorable exam could cancel your benefits or force you to go back to work while you are ailing. Why is the insurer asking for an IME? Are you required to go?

What is 'own occupation' and 'any occupation' disability?

There are two main categories of long-term disability insurance (LTD), based on the definition of disability. The first threshold is “own occupation,” meaning that you receive disability benefits if you are unable to perform your regular job. The other threshold is “any occupation,” meaning that you receive disability benefits only if you are unable to perform any gainful employment.

Every LTD policy is different. The fine print matters, particularly the definition of occupation and the definition of totally disabled. Insurance companies are notorious for selling these policies at significant premiums and then denying claims or terminating benefits. Make sure you read the terms of coverage carefully and talk to an attorney if you ever need to invoke the policy.

Why you should talk to a lawyer before your file an LTD claim

You purchased long-term disability insurance as a hedge against a disabling injury, medical condition or mental health issue. It’s the only way to protect your livelihood, because workers’ comp will not pay anywhere near the income you were earning as a practicing professional.

If that dreaded day comes, you will have to file a disability claim against your policy. Despite diligently paying your premiums every month, there is a high chance your claim will be denied. Your best bet may be to talk to an insurance lawyer before you submit that claim. Here’s why.

Mental health is the new battleground in disability claims

At a time when more people are dying by suicide or overdose, those seeking treatment for mental health issues and addiction face major barriers. Namely, insurance companies are deploying many tactics to deny or limit mental health coverage.

This includes professionals and others who have long-term disability insurance. Mental health claims are denied or downplayed by insurers at a greater rate than medical claims, despite federal legislation.

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