This is the first in a series of articles designed to showcase various topics related to disability claims that are particularly relevant to medical professionals. When a client seeks our assistance regarding their need to file a disability claim under an insurance policy, we first determine when they became disabled. If…
Insurers are still permitted to include “pre-existing” limiting provisions in its disability policies. Cigna policies provide that ” The Insurance Company will not pay Disability Benefits for any period of Disability caused or contributed to by, or resulting from a Pre-Existing Condition.” A “Pre-existing Condition” means “any Injury or Sickness…
We are often faced with dealing with a claim administrator who services a self-insured plan. A recently published case highlights the issues that arise and is useful precedent for the cases we handle for our New Jersey disability clients. In this case, May v. AT&T, AT&T retained Sedgwick to perform…
Just recently, Bonny G. Rafel was successful in an appeal for a New Jersey woman who suffers from multiple conditions primarily associated with Crohn’s Disease and the treatment necessary to treat this serious condition. MetLife Insurance Company denied her claim for Crohn’s Disease. We knew that in order to succeed…
Recently, I met with a 59 year-old medical professional who had been battling a degenerative muscular disease and was contemplating filing for disability benefits after years of battling through pain and limitations on the job. Despite the fact that his condition left him constantly having to send clients out to…
Ms. Rafel recently won an administrative appeal filed on behalf of her client suffering from Parkinson’s Disease. Prudential Insurance Company had denied benefits claiming that there was no proof that the physical symptoms were so disabling as to render him unable to work as a retail stock broker. Prudential relied…
Bonny G. Rafel announces that she recently convinced US Life to reinstate the Business Overhead Insurance benefits to her client, an orthopedic surgeon, after denying benefits on the basis that he can still perform the duties of an orthopedist in an office based setting. The insurance policy was issued through…