In general, if a group insurance benefits plan pays benefits such as medical bills or disability benefits related to an event caused by another “third party”, such as an automobile accident, the plan has the right to recoup their payment from the claimant’s collection of money (“recovery”) from the “third…
The law on marijuana use is rapidly changing nationwide. To date, 23 states have legalized some medicinal use of marijuana, with legislation pending in three additional states. Most notably, 2012 ballot initiatives in Colorado and Oregon legalized recreational marijuana use. Further, additional jurisdictions have decriminalized marijuana, and some prosecutors, such…
Often times, we are approached by clients who are denied disability claims because of mental health issues (i.e., posttraumatic stress disorder, social anxiety, or major depressive disorder). The main reason why these clients are denied disability is because mental illnesses are hard to prove, and it is even harder to…
We are often faced with assisting a disabled client who has been denied benefits from Cigna, Prudential, Aetna, Hartford or Unum based on a brief video surveillance of their daily activities. Our clients ask us, how can a company justify a denial on the flimsy basis that they saw me…
In May of this year, a four year Targeted Market Conduct Examination of CIGNA and Life Insurance Company of America (LINA)’s Disability Income Insurance Claim Handling Practices was concluded by the Departments of Insurance in Maine, Massachusetts, California, Connecticut and Pennsylvania. Review the Regulatory Settlement Agreement of May 13, 2013.…
A key to a successful disability claim is support from your treating doctors. They will be called upon to complete forms and often are requested to speak with medical consultants from the insurance companies who will ask them to confirm your restrictions and limitations. We recognize the importance of working…
A four year Targeted Market Conduct Examination of CIGNA and Life Insurance Company of America (LINA),’s Disability Income Insurance Claim Handling Practices was just concluded by the Departments of Insurance of Maine, Massachusetts, California, Connecticut and Pennsylvania. Review the Regulatory Settlement Agreement of May 13, 2013. See CIGNA’s discussion of…
As more and more individuals establish an online presence, insurance companies are looking to cyberspace to investigate – and in some cases find evidence which may support the denial of insurance disability claims. The implications are twofold. “E-investigations” provide a method of ensuring that only valid claims are paid and…
The Supreme Court is hearing oral arguments on the Patient Protection and Affordable Care Act (commonly known as “Obamacare”) this week, and one of the tenets of the act contains new standards governing the application of pre-existing condition exclusions in insurance policies (see See Report of Congressional Research Service). Against…
Litigants should beware of posting information on social networking sites such as Facebook and MySpace. Not only can your public pages be viewed and possibly used against you in court, judges are now sometimes ordering litigants to reveal their usernames and passwords to opposing parties in litigation. A Pennsylvania court…