Michigan Long Term Disability Insurance Lawyer Blog

In my continuing effort to do the best job that I can for my Long Term Disability Insurance clients I attended that ACI Long Term Disability Insurance Conference in Boston this past week. For the the second year in a row that I have attended this conference I thought it was excellent. The seminar presenters were all top notch-clearly some of the best and brightest practicing in this niche area.

There were a number of very interesting and useful sessions dealing with the Supreme Court's Metlife v Glenn decision and how it is impacting cases across the country as well as various other in depth discussions on a number of relevant issues. The last day we had a panel of a half-dozen federal court judges discuss their view's of these cases.

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Colorada recently passed a law banning the use of discretionary clauses in any Long Term Disability insurance policy. This ban also applies to group policies. Colorado's new law reflects the same policy decision of the Michigan Insurance Commissioner.

Banning these discretionary clauses, and requiring that a court review the claim on a “de novo” basis means that the court must perform its own review and decide whether the administrator’s decision was right or wrong, with absolutely no deference given. This will, in all likelihood, have a huge effect on the number of viable Long Term Disability claims in Colorado.

Thanks to Attorney Shawn McDermott for his blog on this subject.

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Most Long Term Disability policies only provide benefits for a limited time while the insured is disabled from his or her own occupation. This time period is known as the "own-occupation" period. Typically, it is easier for a policy holder to meet this definition of disability because he or she only need establish that they cannot perform the duties of a single occupation-their own. For instance, in a recent case we handled, a registered nurse who was in a serious car accident and suffered a back injury was found disabled because she could not stand on her feet for eight hours and had lifting restrictions that prevented her from assisting patients in and out of bed.

However, after a limited time, usually 24 months, the typical policy provides that benefits are only payable if the insured is disabled from performing any occupation. The Long Term Disability insurance companies normally perform a complete review of every claim when the definition changes and will often use this change to terminate benefits finding that the insured can perform some job. Frequently some nonexistant job for some nonexistant company.

Accordingly, anyone looking to purchase Long Term Disability Insurance should be aware of this important issue.

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Not all long term disability policies provide the same quality, type, degree and level of coverage.
The Consumer Federation of America has a nice article discussing various aspects to consider before purchasing a Long Term Disability Insurance Policy.

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Posted In: LTD Policy Issues

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