People often contact us asking how they can be approved for Social Security Disability benefits yet be denied by their insurance company. Another recurring question is how the insurer can rely on the opinion of a physician hired to perform a file review over the opinion of a treating physician. While insurance companies are allowed to make a decision that is different from the SSA and/or rely on their own file reviews in many cases, they cannot do so arbitrarily. In other words, they have to provide a reason why they rely on such information over other, perhaps more credible information.
Continue Reading Michigan District Court overturns denial of benefits by Liberty Life Assurance Company of Boston
Michigan
Disabled Marquette General Hospital’s Pacemaker Technician Suing Unum Life Insurance for Denial of Long Term Disability Benefits
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A Michigan disability attorney, on behalf of a disabled Michigan client, filed a lawsuit against the Unum Life Insurance Company of America (UNUM) at the District Court for the Western District of Michigan. In Kristina M. Arbelius V Unum Group D/B/A Unum Life Insurance Company of America, the plaintiff Kristina M. Arbelius alleged that…
Insurance Industry Loses Lawsuit Challenging the Abolishment of Discretionary Clauses In ERISA Long-Term Disability Policies
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In 1989, The US Supreme Court declared that if ERISA plans contain language giving plan fiduciaries discretion to interpret the terms of the plans and to make benefit determinations, courts will generally yield to that discretion.
Continue Reading Insurance Industry Loses Lawsuit Challenging the Abolishment of Discretionary Clauses In ERISA Long-Term Disability Policies