Disability Insurance Lawyer Blog

ANOTHER SURVEY - THIS TIME, THE BAD NEWS

At Frankel & Newfield, we keep an eye on the business side of the insurance business. We recently spotted a survey produced by JHA, by a division of General Re Life Corporation that featured participation by 27 disability insurance companies that reads like a list of our adversaries. It reveals the sad state of affairs for the disability insurance sector.

For the first time in ten years, both Long Term Disability and Short Term Disability premiums are down. The downward trend is clear - LTD sales are down from a 13% growth rate in 2000 to negative 2% in 2009. A few factors are in this mix: many companies have closed, or have let large numbers of employees go. Many employers have chosen to eliminate disability coverage altogether. The ten year combined annual growth rate has reached the lowest level seen by the sector in many years.

The report references a need for increased marketing efforts and adapting policies to meet the changing needs of the marketplace. The recent National Disability Insurance Month was certainly evidence of one way that this sector is trying to step up awareness of the product.

We would wholeheartedly endorse better treatment of claimants as a way to increase sales. With all of the bad news coverage surrounding disability insurance policies, who wants to have money taken out of their paycheck or purchase a private policy, when the expectation is that you won't be able to get the benefits if and when you need them?

Our primary concern is what the decline in sales means for the individuals who contact our firm because their claim has been delayed or denied. The business model is pretty straightforward - the fewer claims paid, the higher profits for the insurance company. If they are selling less policies, we believe that they will strategically deny more claims, and that it will become harder as time goes on to successfully secure the benefits from a disability policy.

SELF-SERVING SURVEY SAYS...... WOULD YOU BELIEVE A SURVEY FROM THE INSURANCE COMPANY THAT BROUGHT YOU MET LIFE v. GLENN?

The fact that a vice president of Group Disability Products is quoted in a press release stating that he "finds it disturbing that the vast majority of working Americans have not adequately protected one of their most important assets - the ability to earn an income" is exactly what anyone would expect from one of the largest marketers and underwriters of Long Term Disability Insurance.

Unfortunately, it comes from a company whose name appears as a lead case in no less a venue than the United States Supreme Court, for practices that seem geared more to denying claims than to paying them. Met Life v. Glenn is known in every disability insurance law firm as the case where the Court recognized that there is a real problem.

How ironic, then, that the same company publishes a report "Putting a Face on the Emotional and Financial Impact of Disability" is the same one that delays and denies claims to our clients. We see these faces and we hear about impact on lives when their MetLife claims are delayed and denied.

One final note about this study - MetLife hired a research company to survey 300 people. We have been contacted by at least that many who had real problems MetLife disability insurance and have been put through the wringer. Maybe MetLife should survey them!

If you have a MetLife disability policy and you are facing problems with a claim, call our office. This is one battle you don't have to fight alone.

Hartford's Conduct Found Arbitrary and Capricious

A Federal Court in Ohio has determined that Hartford's reliance upon the opinion of a non-examining, paper reviewing physician, was not sufficient to support a termination of disability benefits to an insured. Hartford relied upon the opinion of a physician provided by MES Solutions, an entity seen regularly as providing insurer favorable doctors to write reports justifying a termination of disability benefits.

Dr. Baum, hired by Hartford through MES, determined that the claimant had sedentary work capacity (able to work 8 hours a day, 5 days a week), despite clinical and objective findings in the record supporting impairment. When additional documentation was submitted, including the results of functional capacity testing supporting impairment, Dr. Baum refused to alter his opinion and Hartford maintained its claim position.

The Court opined that Hartford abused its discretion in terminating disability benefits, because of its conflict of interest, Dr. Baum's failure to document what evidence he rested his opinion on, his failure to consider all evidence, and Hartford's failure to consider the occupational requirements of the insured's occupation.

The Court was also troubled by the lack of any in person examination, and instead the reliance upon a paper review of medical records. This is an all too common issue seen, where insurers are relying upon opinions of non-examining doctors who do incredible volumes of work on behalf of insurance companies.

Bowers v. Hartford Life (S.D. Ohio, May 17, 2010)

FRANKEL & NEWFIELD EXCEEDING EXPECTATIONS FOR OUR CLIENTS - AND THEY WRITE TO TELL US

While most of our blog posts concern successful disability insurance matters on behalf of our clients, news about disability insurance, the law, or various items that we feel will be helpful to our readers, every now and then we receive an email from a client that makes us pause in our busy practice and remember just why we do what we do, day in and day out.

We recently received a note, completely unsolicited, from a client that we are proud to share with you. Our client, 57 years old, had a policy from Equitable. He suffers from Chronic Peripheral Neuropathy, and his illness made it impossible for him to perform in his position as an independent Project Funding and Due Diligence analyst. He recently sent us this note, which we share with you in its entirety. His name is left out for reasons of privacy and confidentiality.

Justin,

XXXX.

If you are having a problem with a disability insurance claim, or are about to file a claim, give our office a call. As our client said quite clearly, the DIY method doesn't work in this situation. We can help.

National Disability Insurance Awareness Month - Is there a Greeting Card for That?

We don't mean to be facetious, but as a law firm fighting with long term disability insurance companies on a daily basis, it's hard for us to take the designation of May as the National Disability Insurance Awareness Month seriously.

Yes, disability insurance is a necessary part of any financial plan. Protecting the paycheck that keeps you and your family in your home, pays the bills and keeps the wolf at bay is an important financial planning product, and we recognize that. But a national awareness month?

Here's what we think you should be aware of: if you become disabled and cannot work because of illness or injury, be prepared to put up an aggressive fight to protect your disability benefits. Chances are good that your first attempt at filing a disability benefit claim will be denied or delayed.

Insurance companies expect you to accept their decision - and remember, it costs the long term disability insurance company nothing to turn you down. If you fight back, they only have to call on their legal department. In most cases, there are no punitive damages or penalties for the insurance company other than to ultimately pay a claim, while they have had the use of YOUR money. Often, all they might have to do is pay you what they would have paid you in the first place. So the responsibility for defending your benefits, unfortunately, is on the individual least likely to be able to fight back - you.

If you are about to file a claim for disability insurance benefits and want to be prepared, call our office. If your claim has already been denied, and you don't know what to do, call our office. If it seems that your claim is moving at a snail's pace, and you suspect that the insurance company is stalling, call our office.

At Frankel & Newfield, we have focused our legal careers on fighting to defend policyholders against disability insurance companies. Give us a call. We can help.