My Disability Erisa Claim Has Been Denied – What Are My Next Steps?

You receive a letter from your insurance company advising you that your disability claim is denied or terminated.   After the initial shock wears off, here are the steps you should take to obtain your disability benefits. Step 1 – Do not request an appeal before you collect all necessary paperwork for your claim. All too often, one’s first reaction is to write their insurance provider telling them they have made a mistake and asking them to reconsider your claim.  While you will eventually speak to your insurance provider about your claim denial, you must first take these additional steps. [...]

By |2010-07-08T19:47:00+00:00July 8th, 2010|Legal Updates|0 Comments

Accidental Death Claim: Drug Overdose Death

Our client’s son died as a result of an accidental drug overdose.  The father was the beneficiary on the accidental death insurance policy.  Insurance company refused to pay the benefits claiming that the death was not “accidental.”  The question came down to whether it was reasonably foreseeable that one would die as a result of taking illegal drugs (in this case heroin).  […]

My Space, Facebook Could Damage Disability Case

Facebook, Twitter, My Space, etc. (collectively referred to as social media sites) are popular with people of all age groups. Long term disability insurance companies and their attorneys use these sites also, to get information about YOU. There may be valuable information about you on these sites that could severely damage your long term disability claim. […]

By |2009-10-15T19:55:00+00:00October 15th, 2009|Legal Updates|0 Comments

Lump Sum In Lieu of Future Disability Payments?

Frequently an insurance company that has been paying monthly disability payments to you will offer to cash you out. What this means is that in lieu of the future monthly disability benefit payments they will offer to fully discharge the future obligations by paying you a lump sum of money. You will receive a letter from them outlining what will be paid and how the amount will be calculated. Before agreeing to settle on this amount, several factors need to be assessed such as the present value of your claim; your statistical life expectancy; and the anticipated future interest rates. [...]

By |2009-07-16T15:30:00+00:00July 16th, 2009|Legal Updates|0 Comments

Death Caused by Accidental Overdose of Prescription Drug is Covered Under an Accidental Death Policy

Accidental death policies, by definition, provide benefits when the insured dies as the result of an accident. However, not all accidents are covered since most policies have exclusions limiting the type of accidents that will be covered. State Insurance Codes have placed limitations on what exclusions an insurance company can place in such policies. […]

By |2008-12-02T18:49:00+00:00December 2nd, 2008|Legal Updates|0 Comments

Blue Cross of California Settles Class Action Lawsuit to Simplify/Clarify Applications

In newer life insurance, disability insurance, and health insurance polices (less than 2 years old) insurers attempt to avoid paying claims by performing what is known as “post claim underwriting.” When you purchase a health, disability or life policy, you fill out an application that asks questions about you and your family’s health, give the insurer a medical authorization, and sometimes undergo a medical exam. Instead of using the authorization to get the applicant’s medical history before wrting the policy, the insurance company waits until a claim is made. At that time, they obtain your medical records to determine if [...]

By |2007-06-19T16:20:00+00:00June 19th, 2007|Insurance Companies, Legal Updates|0 Comments

What is an Administrative Appeal?

You have applied for benefits under an employee benefit plan and you have received a letter from the insurance company or plan administrator informing you that your application for benefits is denied. Whether you are applying for disability, life, health or other benefits the letter advises you that you have a right to an administrative appeal or review of your claim. This article is about that process – what is an administrative appeal or administrative review; what are your rights and obligations; and generally how should you approach this process. […]

By |2007-05-08T15:46:00+00:00May 8th, 2007|Legal Updates|0 Comments
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