December 2010 Archives

Long term care insurance policies, marketed heavily in recent years as a way to protect older persons and provide financial benefits where they are no longer able to care for themselves, have seen a poor claims history, and insurers are reacting aggressively. Met Life has already indicated that they will leave the long term care […]

The 2010 mid-year summary of Group Disability Market results offers some interesting insight into the marketplace for LTD benefits. This survey is published by JHA – a division of Gen Re, a Berkshire Hathaway company. This report is largely published for the insurance industry, but the information is significant to those on the front lines […]

It has been suggested by industry insiders that the demand for critical illness insurance will be a major growth opportunity in 2011. This type of insurance typically pays a lump sum benefit following diagnosis. It is marketed as a supplement to typical disability insurance, to help cover medical bills and other needs. As attorneys for […]

If you spend any time on the

CIGNA had attempted to terminate our client’s claim for long term disability benefits, a claim in which they had previously terminated, only to voluntarily reinstate benefits while in litigation, back in 2008. Two years later, CIGNA again made efforts to terminate the claim, on the purported basis that our client’s treating physicians no longer supported […]

Another court has offered insight into how to determine when a claim administrator acts in an arbitrary and capricious manner. A Federal Judge in Michigan determined that Sedgwisk, a third party administrator of claims for General Motors, abused its discretion, by adopting the opinions of a hired medical reviewer, over the well supported opinions of […]

Peter Orszag, director of the White House Office of Management and Budget from 2009 to July 2010, a distinguished visiting fellow at the Council on Foreign Relations and a contributing columnist for The New York Times has shared his thoughts on what he considers one of the key challenges facing our weakened economy – the […]

In a disturbing decision from a Federal Judge, one court has permitted a long term disability insurance company to hide the identity of its medical reviewers who provided the insurance company with opinions that were utilized to deny benefits to an insured. In Houser v. Alcoa, Inc., a case from the Western District of Pennsylvania, […]

News that the Texas Department of Insurance has adopted a new rule prohibiting the inclusion of discretionary clauses in disability insurance policies makes us right proud of our southwestern neighbors. Discretionary clauses are not typically seen in state-law governed policies, but are present in nearly all employer-provided policies because they are permitted by the laws […]