On December 1, 2014, the U.S. Court of Appeals heard oral argument in the case of Mary C. Fontaine v. Metropolitan Life Insurance Company. The issue before the court was whether an Illinois insurance regulation banning discretionary clauses in health and disability insurance policies survives ERISA preemption claims. The lower court ruled in Fontaine’s favor.
The oral argument may be heard at
When filing a long-term disability (LTD) claim, success often depends on strong medical evidence. Among the most critical forms of proof is medical opinion evidence, which includes expert assessments from healthcare providers about your condition and limitations. […]
During its most recent term, the U.S. Supreme Court overturned a 40-year-old precedent that guided courts in addressing administrative agency interpretations of the laws they regulate. In Chevron U.S.A. Inc. v. Natural Resources Defense Council Inc.,[1] the Supreme Court ruled in 1984 […]
Most disability insurance policies distinguish between disabilities that are due to medical conditions and those that result from behavioral health disorders. For the latter category, benefit payments are typically limited to a maximum of 24 months, while payments for disabilities resulting from medical conditions can continue until the claimant reaches Social Security retirement age. […]
There have been several important recent developments in how courts are assessing health benefit claims brought under the Employee Retirement Income Security Act. In Dwyer v. United Healthcare Insurance Co.,[1] a case involving a claim for residential behavior health...
Mental health disability claims are denied far more frequently than physical disability claims, creating serious challenges for individuals seeking benefits. In a recent interview on Main & Wall, disability benefits attorney Mark DeBofsky shared his thoughts on...
Defined benefit (DB) pension plans used to be the prevalent form of retirement benefit offered by American employers to their employees. […]