Specializing inInsurance coverage litigation issues

Disability Insurance

There are two types of disability insurance: Long Term and Short Term. Either may be purchased individually or by or for a group, such as part of an employee benefit package. And, the size of the group may determine whether the policies will be underwritten, or not. Individual policies generally are.

These policies generally have specific waiting periods before the benefits are payable: 30, 60 or 90 days. The period commences on the date that there is and income loss and medical treatment as defined in the policy - both the income loss and treatment are conditions to an entitlement to benefits.

Over the years, these policies have changed so that what constitutes a "total disability" has become more restrictive. For example, in some policies if you are disabled from performing the usual duties of "your occupation" it mattered not that you could perform the duties of some other occupation for which you were reasonably suited by education and experience. More current policies will provide for a termination of benefits when you are able to perform the duties of "any occupation" for which you are reasonably suited by experience and education.

Claims under these policies are usually fact intensive, and generally complicated by other laws. For example, if the disability policy was provided as part of an employee benefit package, there may be ERISA [Employee Retirement Income Security Act of 1974] issues which must be identified and addressed.

Simply stated, disability claims are frequently complicated and often result in litigation. If you find yourself confused and denied, call or email us. We can help.