[nap_names id="FIRM-NAME-1"] is proud to announce some of the recent wins we achieved for our clients. In each case, our legal team took on one of the largest insurance providers in the U.S. and won the disability insurance benefits to which our clients were legally entitled. MetLife denial of a mental health claim One case involved a financial services associate for a well-known financial institution. This client was forced to halt his successful career when a triggering event caused symptoms from his bipolar disorder and other mental health conditions to grow unmanageable, making it impossib ..read more

Finding out that your disability insurance provider has denied your claim can be frustrating, confusing and frightening. You and your family were likely counting on those benefits to help make up for your lost wages and allow you to pay household expenses despite being unable to work. Fortunately, a denial does not have to be the last word. With a good Appeal, it may be possible to get the benefits you deserve without having to file a lawsuit or go to trial. The Importance of the Administrative Appeal Your long-term disability (LTD) insurance policy is a contract between you or your employer a ..read more

If you have a disability insurance policy, it is important to understand what that policy covers in case you ever lose your ability to work due to an illness or physical injury. Policies differ with regard to the type of conditions covered, the length of time of coverage, and exceptions that may apply. Below are examples of terms and conditions that vary. Not applying for the appropriate benefit could result in a claim delay or denial. Total vs. partial disability Insurance companies often define a disability as a Total Disability or a Partial Disability. Depending on the Policy, a Partial Dis ..read more

Each year, millions of Americans pay insurance companies for coverage, trusting that if the unexpected happens, the terms of the policy will be honored and their claims will be paid. One type of policy is Accidental Death and Dismemberment insurance. What Is Accidental Death and Dismemberment (AD&D) Insurance? An AD&D insurance policy is exactly what its name indicates - a policy that covers a policyholder in the event of death or dismemberment. This policy is typically added as a rider, or additional coverage, to a health insurance or life insurance policy. It can be provided through ..read more

Your insurance claim has been denied, now what? Dealing with insurance claims that have been denied can lead to frustration, confusion, and discouragement. The reality is, the appeal process can be complex and leave you feeling overwhelmed. We are here to help. First, it’s important to understand that if you obtained your short-term or long-term disability policy through your employment, ERISA (the Employee Retirement Income Security Act of 1974), a federal law, likely applies to your claim. What does this mean? It means that you must follow certain procedures when filing for benefits or when ..read more

Insurance companies that sell short- or long-term disability insurance policies are in business to make a profit. It follows that they are not necessarily there to be benevolent supporters of their policyholders when they struggle with disabling health conditions. To that end, it is unfortunate that most disability insurers have the same arrows in their quivers – a set of underhanded claim processing tactics used not to reach the right decision on a disability claim, but rather to figure out a way to deny it (or to terminate a claimant already receiving benefits). Many people never have to dea ..read more

Most disability insurance policies allow the insurer to arrange for a reasonable, relevant independent medical examination (IME) of the claimant. While on its face this sounds fair and even potentially helpful for a disability claimant, the insurance company may use IME findings to deny a claim or terminate disability benefit payments, even in the face of the claimant’s own strong medical evidence. IME Bias A physician who performs numerous IMEs for insurance companies may have an inherent conflict in that they are often paid well by the insurance company to assess a claimant’s functionality ..read more

Life insurance seems straightforward. You buy a policy or get one through your employment that will pay money to your beneficiary after your death. You name your beneficiary or beneficiaries as part of the enrollment process and normally can change your beneficiary choices over the years as relationships evolve or people pass away. Unfortunately, sometimes after a life insurance policyholder has died, the insurance company may not be able to determine the proper beneficiary. Or a dispute develops among two or more people who believe they are the rightful beneficiaries. At this point, life insu ..read more

Many businesses of all types and sizes have business interruption policies as part of their insurance portfolios to protect their livelihoods in case of sudden inability to continue doing business because of outside forces. Most commonly, business interruption insurance pays out to the commercial policyholder in case of a disaster like a hurricane, wildfire or tornado that causes loss of business earnings and raises costs. Of course, many restaurants, retailers, entertainment providers, nonprofits and service companies are currently shuttered or operating at a greatly reduced capacity because ..read more

In this time of COVID-19, many people are experiencing extreme stress, even trauma, as first responders, medical personnel, those susceptible to the new coronavirus because of advanced age or underlying medical conditions, those who do become ill and those facing financial loss – and the families and loved ones of all of these people. After these disturbing experiences, some will develop posttraumatic stress disorder (PTSD). In addition, InStyle reports that both people facing COVID-19 directly in their lives and those quarantining at home are “all susceptible to long-term mental health issues ..read more