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UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock

UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock October 15, 2018. By Anne Wallace.
Chattanooga, TN On September 25, 2018, the Sixth Circuit Court of Appeals granted UNUM Life Insurance’s motion for summary judgment, thus ending Richard Ravenscraft’s UNUM disability lawsuit on the grounds that he had not exhausted administrative remedies. These are the rocks on which many long term disability lawsuits have been dashed.
Read [ UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock ]

Mother with Post-Partum Depression Denied Disability Benefits by Hartford

Mother with Post-Partum Depression Denied Disability Benefits by Hartford October 10, 2018. By Jane Mundy.
Chicago, IL: Even though Angela tried to return to work after suffering from postpartum depression, her boss advised that she apply for long term disability with Hartford Health Insurance. But Hartford didn’t agree with Angela’s boss.
Read [ Mother with Post-Partum Depression Denied Disability Benefits by Hartford ]

Prosthetic Denial Lawsuits Filed against UnitedHealth Group and Anthem under ERISA

Prosthetic Denial Lawsuits Filed against UnitedHealth Group and Anthem under ERISA September 24, 2018. By Jane Mundy.
Santa Clara, CA: Prosthetics with a variety of microprocessors are the new “wearable technology” and they’re making headlines. Companies have designed the devices with
Read [ Prosthetic Denial Lawsuits Filed against UnitedHealth Group and Anthem under ERISA ]

Amputees Fighting for Insurance Coverage Get Tips from Blue Cross Antitrust Lawsuit

Amputees Fighting for Insurance Coverage Get Tips from Blue Cross Antitrust Lawsuit September 20, 2018. By Anne Wallace.
Wilmington, DE As amputees fight for insurance coverage for advanced, microprocessor- assisted prostheses, it can help to look at other insurance lawsuits that describe a similar pattern of claims denials.
Read [ Amputees Fighting for Insurance Coverage Get Tips from Blue Cross Antitrust Lawsuit ]

Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman

Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman September 14, 2018. By Anne Wallace.
San Diego, CA Christopher Wheeler was a Coxswain/Diesel mechanic, a contractor doing heavy physical work for the U.S. Navy Fifth Fleet. On March 17, 2015, he was badly injured during a storm at sea off Bahrain. Hospitals and rehab landed him a computer job for which he had no aptitude or training. When that didn’t work out, his employer, Exelis, Inc. terminated his employment and Metropolitan Life Insurance (MetLife) denied his long term disability benefit application. He filed a long term denied disability lawsuit on August 2, 2018 in the Southern District of California. California’s de novo standard for the review of disability claims under ERISA may work to Wheeler’s benefit.
Read [ Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman ]

Dentist Claims Injury, Unum Claims Sickness to Deny

Dentist Claims Injury, Unum Claims Sickness to Deny September 13, 2018. By Jane Mundy.
San Diego, CA: A dental surgeon has filed a bad faith lawsuit against Unum, or First Unum after the giant insurer denied his long term disability benefits claiming his injury is a sickness. The Unum lawsuit claims that Unum denied the dentist his rightful benefits to protect their own interests.
Read [ Dentist Claims Injury, Unum Claims Sickness to Deny ]

Amputees’ Fight for Insurance Coverage Focuses on ‘Medical Necessity’ of Microprocessor Prosthetics

Amputees’ Fight for Insurance Coverage Focuses on ‘Medical Necessity’ of Microprocessor Prosthetics September 4, 2018. By Anne Wallace.
Washington, DC Lucky to live, unlucky to lose a foot or a leg, survivors of the Boston Marathon bombing soon found themselves facing the harsh truth of inadequate insurance coverage for their prosthetic care. Years on, the good news is that microprocessor-enhanced artificial limbs have gotten better. The bad news is that insurance companies like Anthem and United Healthcare still balk at paying for them. Insurance lawsuits since then have taken particular aim at the internal review standards insurers use to determine whether a medical treatment or device is “medically necessary.” The standards do not line up with what amputees need most and what these modern devices can really do. Cost cutting vs. good health – it’s the match of the century.
Read [ Amputees’ Fight for Insurance Coverage Focuses on ‘Medical Necessity’ of Microprocessor Prosthetics ]

Aetna Denies Disability – Is there a Doctor in the House?

Aetna Denies Disability – Is there a Doctor in the House? September 3, 2018. By Jane Mundy.
Los Angeles, CA: California's insurance commissioner in February 2018 launched an investigation into Aetna after discovering a former medical director for the insurer (independent medical examiner) admitted under oath that he never looked at policy holder’s records to decide whether to approve or deny their long term disability benefits. Now a California woman has filed a complaint against the huge insurance provider claiming a similar issue.
Read [ Aetna Denies Disability – Is there a Doctor in the House? ]

Lawsuits Brewing over Insurance Denials for “Smart” Prostheses

Lawsuits Brewing over Insurance Denials for “Smart” Prostheses August 21, 2018. By Anne Wallace.
Los Angeles, CA In California and other states, amputees are denied insurance coverage for modern prostheses. These legs and ankles are hugely better than the old titanium alloy stilts because of their microprocessors. Lt. Dan was glad to stand with his bride, but imagine running up the stairs or dancing at a Gump-ish wedding. Nonetheless, Anthem, United Healthcare and other insurers plead shock, confusion, and a general lack of evidence when asked to pay for the more modern prosthetics. The ensuing insurance lawsuits have taken aim at the insurers’ claims that the advanced prostheses are not medically necessary or still experimental.
Read [ Lawsuits Brewing over Insurance Denials for “Smart” Prostheses ]

Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits

Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits August 14, 2018. By Jane Mundy.
Santa Clara, CA: As a disability claims consultant and former Unum employee, Linda Nee knows just about every trick in the insurance company’s books to dispute and deny disability benefits to claimants. She says that Unum, or First Unum is “nickel and diming” its policy holders by alleging overpayments associated with SSDI and other monthly earnings offsets, including Retirement Income.
Read [ Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits ]

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