Bartolic Law has helped clients get their long-term disability and life insurance claims paid by Standard. In one case, a highly compensated client suffered from numerous spinal disorders, resulting in an inability to sit and stand as much as required for full-time work. Standard asserted the client’s work schedule was below that required for the position, and based a denial on the condition not worsening since the client stopped working. We demonstrated numerous problems in both the medical and vocational review and successfully got the client’s claim in pay status, allowing the client to live with financial dignity. In a life insurance case, Standard denied payment to our client, asserting the client’s spouse lost life insurance coverage after leaving employment. We were able to retroactively demonstrate the insured qualified for premiums waived due to disability, and retained coverage. It did not spare our client the grieving, but it helped the client live more comfortably under the circumstances.
Many long-term disability insurance policies have monthly benefit maximums ranging from $10,000–$20,000. Standard offers additional insurance for highly compensated employees, like C-level executives, Senior Vice Presidents, lawyers, accountants, and even doctors. It does so under the “Guaranteed Standard Issue” product.
When you combine multiple insurance policies with one insurer, you increase your coverage, but do not diversity your risk. If that one insurer decides to deny a claim, all your income protection may be at risk. If you have a supplemental policy with the same insurer as your base policy, it may make sense to get guidance before making a claim.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)