Disability Insurance Law TV:
Who makes the final decison to approve or deny disability insurance benefits?
Is it the disability insurance claim representative or hired insurance company doctor that makes the decisional to approve or deny benefits?
FAQ | Overpayment Issues:
Can Veteran Disability Benefits be deducted from my monthly long term disability insurance check?
The answer to this question depends on the language contained within your long term disability insurance policy. In most disability claims that are governed by ERISA there is an offset provision for other disability related benefits such as SSDI, Worker Compensation or Veteran Benefits.
A federal district court in Pennsylvania recently dismissed Claimant Barry Sunshine’s complaint for lack of subject matter jurisdiction. Alleging that Reassure America Life Insurance and Swiss Re Life & Health America, Incorporated prematurely terminated his and other similarly-insured individual’s disability insurance benefits, Sunshine and his disability attorneys were attempting to right a wrong for not only Sunshine but for others in a similar situation. Unfortunately, the Eastern District Court of Pennsylvania dismissed Sunshine’s disability insurance class action lawsuit because the suit lacked federal subject matter jurisdiction. Fortunately, the dismissal was filed as a dismissal without prejudice, making it possible for Sunshine to file an amended complaint when his disability attorneys establish proper subject matter jurisdiction.
An affirming opinion from the Fourth Circuit United States Court of Appeals shows how Administrators of ERISA long term disability benefits can’t abuse their power of discretion in North Carolina. This case against LINA also known as CIGNA, is a great victory for claimants suffering from fibromyalgia. In the appeal of Rebecca DuPerry v. Life Insurance Company of North America, Appellee Rebecca DuPerry prevailed in her quest to receive long-term disability benefits from her group long term disability insurance provider, Life Insurance Company of North America (LINA).
UNUM Life Insurance Company of America has refused to honor its obligation to provide Scott A. Boles with his disability insurance benefit income even though Mr. Boles qualifies for benefits stipulated in two UNUM Life Insurance Company disability insurance policies. UNUM denied Mr. Bole’s disability insurance benefits on both his individual disability policy, on which he has paid all premiums on time and in full since 1994, as well as an employee group disability policy from his employer that has been in effect since 2006.
Disability Blog & Cases:
Sun Life deducts veteran disability benefits from claimant’s monthly long term disability check
Most long term disability insurance policies allow the insurance company to offset the monthly disability payments to an insured if the insured is receiving “other income” from certain sources. Often, these other sources include any Social Security disability or retirement benefits, workers’ compensation benefits, retirement plan benefits from the employer, or even earnings the insured receives from any other occupation or form of employment. The specific policy language governs exactly what the insurance carrier can consider an “offset” to reduce the claimant’s monthly benefit. Sometimes, however, the insurance policy is not crystal clear on what specifically may be used as an offset. Such a situation occurred in the case of James Riley v. Sun Life Insurance Company. In this case, the issue was whether Sun Life was allowed to reduce Riley’s monthly benefit because of veteran disability benefits he received from Veterans Affairs. The Court ultimately upholds Sun Life’s decision to reduce Riley’s monthly long-term disability benefits. Let’s take a closer look to see why the Court ruled the way it did.