SMDA was recently able to help a disabled dentist recover on his individual disability insurance policy after his claim for total disability benefits was denied. The LTD insurer had denied his claim when it discovered that he had opened a small tap room/eatery. SMDA was able to convince the disability…
It can be confusing trying to figure out the amount of Long Term Disability Insurance benefits the insurance company should pay. Here is a brief outline of how the amount is commonly determined. Step 1.-Figure out your base monthly income. (Take your yearly income and divide by 12. Beware however-commonly…
Almost every Long Term Disability Insurance Policy I have ever reviewed contains a limited period (usually 24 months) of time that it will pay benefits if a claimant is unable to perform the duties of his/her “Own” (see prior post on how “Own” occupation is misleading) occupation. The plans most…
I was recently asked to review a claim denial by a well know disability insurer for a nice lady who suffered a terrible crush injury to her foot. She had worked at a production facility where her job duties required her to be on her feet for extended parts of…
As a follow up to the last post, the US Supreme Court sided with the Hartford Life and Accident Insurance Company enforcing its contractual limitations period. In Heimeshoff v Hartford Life and Acc. Insur. Co., ______S.Ct. _______ (2013). the Court concluded that: Because proof of loss is due before a…
In my continuing effort to do the best job that I can for my Long Term Disability Insurance clients I attended that ACI Long Term Disability Insurance Conference in Boston this past week. For the the second year in a row that I have attended this conference I thought it…
Colorada recently passed a law banning the use of discretionary clauses in any Long Term Disability insurance policy. This ban also applies to group policies. Colorado’s new law reflects the same policy decision of the Michigan Insurance Commissioner. Banning these discretionary clauses, and requiring that a court review the claim…
Most Long Term Disability policies only provide benefits for a limited time while the insured is disabled from his or her own occupation. This time period is known as the “own-occupation” period. Typically, it is easier for a policy holder to meet this definition of disability because he or she…
Not all long term disability policies provide the same quality, type, degree and level of coverage.The Consumer Federation of America has a nice article discussing various aspects to consider before purchasing a Long Term Disability Insurance Policy. Related Posts: “Own” vs “Any” Occupation in Long Term Disability Insurance Plans, The…