California case law is clear that an insured’s attempt to return work may not bar a finding of disability. The California courts have long recognized
Even In An ERISA Case, The Disability Insurer Must Consider the Insured’s Actual Job Duties
Some disability insurance policies include a provision that the insurer will try to use to disregard the insured’s actual job duties in deciding whether the
An ERISA Insurer Cannot Refuse To Credit The Claimant’s Medical Evidence Without A Sufficient Explanation
In the recent case of Backman v. Unum Life Ins. Co. of Am., 2016 U.S. Dist. LEXIS 74918 (N.D. Cal. June 8, 2016), in which the
In Many ERISA Cases, The Disability Insurer Should Be Barred From Requiring “Objective Evidence” Of Disability
In ERISA claims, disability insurance companies often state in their denial letters that the insured does not qualify for benefits because he has not stated “objective
When Does An Insurance Company Act In “Bad Faith?”
If your insurance company denies your disability insurance claim and your case is governed by California law, proving “bad faith” is a two-step process.
What is the definition of “disability” and “total disability” in California?
If your insurance company has denied your disability insurance claim and your claim is governed by California law, you must establish that you are disabled under California law.
What are the deadlines in California for suing an insurance company?
Unless the insurance company has inserted an enforceable provision in the policy limiting the time within which you may sue and, secondly, it is not unfair under the circumstances for the insurance company to impose...
How The Insurance Company Uses The “Vocational Expert” To Support A Denial
Insurance companies use a “vocational expert” to assist them in denying claims. Rather than assess whether the policyholder is able to perform his or her actual
The Insurance Company Doctor’s Techniques To Support A Denial
The insurance company doctor is an essential cog in the insurance company’s denial mechanism. The insurance company doctor typically writes a memo or report on which the insurance company purports to base its claims decision.
A Pillar Of The Insurance Company’s Denial: The Insurance Company Doctor
A technique essential to an insurance company in denying claims is the hiring of a physician consultant on whom it can rely to support its denial.