Confidentiality clauses – why insurers love them, and why they should be abolished.
Most of my cases settle, often at mediation. Typically the insurer will bring a “standard” form of release to the mediation for my client to sign. If not, when the insurance company’s lawyer sends me the cheque it will be accompanied by a form of release which my client must sign in order to receive the settlement funds. In either case, the release will always contains something not usually discussed – a confidentiality clause. A confidentiality clause prohibits the parties to a settlement from disclosing the settlement terms. Confidentiality raises numerous problems. It can be bad for...
read moreAre my LTD benefits taxable or not? It depends.
When assessing a litigated claim for long-term disability benefits, one very important consideration an insurance denial lawyer must always be aware of is whether the long-term disability benefits are taxable or non-taxable under the specific disability policy at issue in the claim. Long-term disability benefits are typically taxable under a policy when an employer pays a portion (or all) of the insurance premiums on a disability policy. Long-term disability benefits are typically non-taxable under a policy when an employee pays 100% of the insurance premiums on the disability policy. It...
read moreMy most memorable case of 2016.
The past year has seen many interesting and surprising cases land on my desk. But my most memorable case involved a woman I’ll call April. April had been employed by a financial institution for a number of years when she developed cancer that forced her to stop work in May 2001. She applied for long-term disability benefits under her employer’s group insurance policy. Her claim was approved and benefits were paid starting in November 2001. Although the cancer treatment went well, April developed a number of mental illnesses including major depression, a generalized anxiety...
read moreCan my insurer contact my doctor directly?
Your disability insurance company has asked your treating physician to complete a questionnaire regarding your ability to work and current medical condition, what should you do? Requesting that updated questionnaires be completed by a claimant’s treating physicians seems to be standard in the review process. Usually, these forms consist of yes or no questions, check boxes and requests for comments on restrictions and limitations. If you know the insurance company has requested such questionnaires from your physicians it is a good idea for you to make an appointment with your physician...
read moreWhy an insurer may ignore a treating doctor’s opinion.
Many people, as well as their doctors, believe that when they file a claim for disability benefits their disability insurance company has to accept the medical professional’s opinion that they are disabled. Common sense suggests this is a reasonable assumption – but it couldn’t be further from the truth. Why? Because many insurers simply do not want to pay disability claims and, when armed with discretionary language in the policy, the insurer has the final say as to who is “disabled”, not the treating doctor. Making matters worse is the fact that the insurance company is...
read moreReducing work hours may imperil disability coverage.
Many people who are struggling to work due to an acute unexpected medical condition do not have the opportunity to prepare or plan for filing a short and or long term disability claim. My experience is that most people who eventually file disability claims have chronic medical conditions which have been ongoing for months and even years. During this difficult period disabled people often find themselves engaged in an heroic effort to continue working. People engage in this long battle for many reasons, one is often financial, and the other is simply their own credibility – they like...
read more
