I've Been Denied by My Insurer. What Now? The answer to this question is simply: if your claim is governed by ERISA, obtain legal representation. Let me explain to you why it is so very important to get an attorney involved, and why it is important to do so immediately. If your claim is governed [...]
If you have a disability insurance policy from your employer, it is most likely governed by ERISA. (Employee Retirement Income Security Act.) Your attorney fees can be recovered if you sue and win. It will be up to the judge to determine whether the insurance company should pay your attorney fees. Under ERISA, a claimant [...]
It is rare that an insurance company will be awarded its attorney fees in defending your long-term disability claim in federal court. While the law allows the insurance company to apply for payment of its attorney fees if it wins your disability case, it is rare that a court will make you pay. In one [...]
A long-term disability insurance company cannot define your occupation for you. Long-term disability insurance policies typically pay a benefit if, through injury or sickness, you are no longer able to perform the material duties of your occupation. Insurance companies will often try to "generalize" your occupation so that it will be easier to deny benefits. [...]
There are two different standards by which your case may be judged. The “de novo” standard of review is what you want. “De novo” means “starting anew,” so in the courtroom this means the judges are looking at the original question the insurance company was supposed to answer: does your disability qualify you for benefits [...]
ERISA stands for “The Employee Retirement Income Security Act of 1974.” That act covers many employee benefits, one of which is private employer disability insurance policies. There are two types of disability insurance policies, only one of which is governed by ERISA. One type is given to public employees (school teachers, police officers, firefighters, etc.). [...]
In the US alone, Long-Term Care Insurance is estimated to have covered 8 million people. LTCI policies come in many varieties. The language of the policies and the technical requirements for filing a successful claim can be very confusing.The attorneys at Robinson Warncke have a great deal of experience in presenting LTCI claims and in [...]
The Washington Post recently published an article addressing one of the common challenges we face in presenting long term disability claims. Although the article focuses on Social Security disability, the concepts are equally relevant to group long term disability claims under the federal law known as ERISA. Most ERISA-governed long term disability policies contain an [...]
On December 31, 2020, New York Life completed its acquisition of all of Cigna’s group disability, accident, and life insurance business. As a result, your Cigna benefit claims are now administered by “New York Life Group Benefit Solutions.” This change applies even if your Cigna claim was approved, and you have been receiving benefits since [...]
Robinson Warncke Sues MetLife under new ERISA regulations This case confirmed the efficacy of the Department of Labor’s (DOL) 2018 revisions to ERISA’s “full and fair review” claim regulations. At ERISA’s inception in 1974, Congress charged the DOL with enacting regulations defining how insurance companies must behave to fulfill ERISA’s guarantee of a “full and [...]
