We learned that many carriers were going to behave as they traditionally do, by denying claims because of policy exclusions for damage caused by flooding and debris flow. But because the underlying cause of loss was the destruction of vegetation by a covered fire, and because we were threatening bad … [Read more...]
Covid-19 Business Interruption Insurance Coverage Announcement
The coronavirus pandemic has forced American businesses to a skidding halt. With nationwide quarantines and closures, COVID-19 has jeopardized the very existence of many businesses. In California, Governor Gavin Newsom has implemented aggressive social distancing measures, including a “Stay-at- … [Read more...]
New Year, New Website!
The Real Definition of And How Residual Disability Deprives Claimants of their Rightful Benefits
While every Long-Term Disability (LTD) policy includes a definition of total disability, many states (including California, Arizona, and Florida) have their own legal definition of total disability. What happens when these two definitions conflict? The answer is that state law will … [Read more...]
Drug and Alcohol Addiction – Long Term Disability
Drug or alcohol addiction or abuse is clearly a disabling condition qualifying for long term disability benefits. If a claimant with a drug or alcohol addiction goes through a rehabilitation program, the question is, whether the disability continues even after the program has … [Read more...]
California Long Term Disability Bad Faith Law – A Fair Deal for Policyholders
So what do you really think. Ray Bourhis? If an insurance company defrauds or cheats a policyholder out of the benefits the policyholder is owed, and if, as a result, the policyholder his or her home or their life savings, or is forced to hire a lawyer to obtain the benefits they are owed, the … [Read more...]
Psychiatric Disability Paper Review Finds Aetna Abused Discretion Kuntz v Aetna
In Kuntz v Aetna, 2013, the Federal Court found that for Aetna abused its discretion in having based its disability claim denial in a mental health impairment case on a paper review of the Claimant’s medical records. Other courts have referred to denials based on such paper reviews as being … [Read more...]
