Navigating Disability Claims Amidst Lingering Post-COVID Symptoms
In the wake of the global COVID-19 pandemic, a new and complex health challenge has emerged: the enduring effects of the virus on some individuals, known as "long COVID" or "post-acute sequelae of SARS-CoV-2 infection" (PASC). As we delve into the intersection of health and disability insurance claims, it becomes evident that the range of persistent symptoms associated with long-term post-COVID can play a pivotal role in supporting disability claims. Understanding The Impact The spectrum of long-term post-COVID symptoms is broad, encompassing a myriad of challenges that can disrupt both personal lives and professional pursuits. Let's explore how these symptoms [...]
Accidental Death Insurance Policy Covers Heroin Overdose Death
A widow, whose husband died of an accidental overdose of heroin, sought benefits under an accidental death insurance policy sponsored by her former husband’s employer. The plan was governed by the Employee Retirement Income Security Act (ERISA). The insurer denied the widow’s claim asserting an exclusion in the policy for “loss caused wholly or partly, directly or indirectly, by… intentionally self-inflicted injury.” The insurer argued that decedent intentionally used in illegal substance that directly resulted in his death. The widow filed suit and the case eventually went before the 8th Circuit Court of Appeals. The court drew a correlation [...]
Death from Drug Overdose Was an Accident – Not Suicide
Client’s husband died from an overdose of a combination of prescribed drugs, including [drug* and drug*] Decedent had suffered from a very painful condition that required long-term use of the prescribed narcotics. Over the last year before his death, he had been unable to work but had hidden that from his wife by pretending to go to work each day. He had been depressed and was in severe financial debt at the time of his death. In order to avoid liability under an accidental death policy, MetLife claimed that the death was not “accidental”, but rather the result of suicide. [...]
Post-Chemo Disability
When a diagnosis of cancer is followed with treatments that include chemotherapy, patients often experience lingering symptoms of fatigue, muscle weakness, brain fog (often called chemo brain), decreased ability to concentrate, and peripheral neuropathy. In some people, these symptoms can last well past the remission of cancer. This is precisely what happened to a client of Stennett & Casino who had a disability policy through her employer with United of Omaha. Omaha provided disability benefits while she was going through treatment. But those benefits were terminated by Omaha after she went into remission. Though her cancer was in [...]
Insurer Rescinds Policy for Failure to Disclose High Blood Pressure
Our client’s husband died unexpectedly at age 48 following a massive heart attack. Fortunately, he had a life insurance policy. Unfortunately, the insurance company denied her claim for benefits. The denial was based on the fact that her husband had not disclosed his history of high blood pressure to the insurance company when he first applied for the coverage. Insurers may rescind a life insurance policy within 2 years of its issuance if it discovers the applicant made a misrepresentation that the insurer reasonably relied upon in issuing the life policy. The key is whether the misrepresentation (whether innocent or [...]
Coverage Under Accidental Death Insurance Policies for Drug and Alcohol Overdoses
Accidental Death and Disability policies (AD&D) require that one’s death be caused by an “accident” to trigger coverage. The term “accident” is usually defined as an “unforeseeable, unintended, and sudden event.” These policies will also contain several exclusions including one for death due to an illness or the treatment thereof. Insurers continually deny benefits under an accidental death policy when death results from an accidental overdose of prescription drugs. When death is caused by medication that is prescribed to treat an illness insurers cite the “illness and treatment thereof” clause to deny the claim. Despite this exclusion Stennett & Casino [...]