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Welcome to Dorian Law PC’s resources page. This is where we blog about useful tips, emerging trends, and provide thoughtful insights regarding LTD, Life, and AD&D Insurance benefits. Search for something you are interested in or check out a topic from the list below. Whatever brought you here, I hope we can make a difference.
- Abuse of Discretion
- Accidental Death Insurance (AD&D)
- Attorneys' Fees
- Bad Faith
- Breach of Fiduciary Duty
- Case Review Corner
- Costs
- Denied Disability Benefits
- Disability Insurance
- Duty to Cooperate
- ERISA
- ERISA Preemption
- Exhausting Administrative Remedies
- Fibromyalgia
- Hiring an Insurance Lawyer
- Individual Disability
- Interpleader
- Legal Ethics
- Life Insurance
- Long Term Disability
- Long Term Disability Insurance
- Long-COVID
- Lupus
- ME/CFS
- Pre-existing Condition
- Provider Reimbursement
- Punitive Damages
- Sedentary Work
- TBI
- Taxes
- Unum
Case Review Corner: Healthcare Providers Beware – Exhausting ERISA Remedies is Crucial
Can a doctor or medical practice sue an ERISA health plan directly for denied payments? A recent court case involving COVID-19 testing provides a clear answer – usually not without first jumping through administrative hoops. Learn why the Murphy Medical Associates' lawsuit against the 1199SEIU National Benefit Fund was dismissed and what it means for healthcare providers seeking payment.
Case Review Corner: The Perils of Non-Cooperation in an ERISA Disability Claim
What happens when you stop cooperating with your insurance company during a disability claim? The case of Kelly Routten against LINA offers a cautionary tale. Despite questions surrounding a pre-existing condition, the court ultimately sided with the insurer due to the claimant's decision to revoke access to her medical records. Discover why cooperation is key to protecting your ERISA disability benefits.
Case Review Corner: Victory for Claimant in ERISA Pre-Existing Condition and Disability Determination Case
Insurance companies often deny valid long-term disability claims, especially when it comes to tricky issues like pre-existing conditions. But sometimes, the claimant wins! Dive into our latest "Case Review Corner" to explore how Jessica Krueger took on Reliance Standard and convinced a federal judge that she was entitled to her benefits despite the initial denial. This is a must-read for anyone facing a tough disability claim.
Is Your Long-Term Disability Claim at Risk? Common Denial Reasons & How Dorian Law Can Help
Don't let a long-term disability claim denial derail your life. Insufficient medical evidence, policy limitations, and even pre-existing conditions can lead to a denial. But what does that really mean, and how can you avoid these traps? This blog post explains the common denial reasons in plain English, with specific examples and advice for both ERISA and non-ERISA plans. Plus, find out what to do if your claim has already been denied.
What Exactly is "Accidental Death" in Insurance?
If you're facing a denied Accidental Death and Dismemberment (AD&D) insurance claim in California, Phoenix (Arizona), Seattle (Washington), Idaho, or Las Vegas (Nevada), Dorian Law P.C. can help. "Accidental death" generally means a fatality resulting directly from a sudden, unexpected, and unintentional event like a car accident, fall, or drowning, but policies exclude things like illness, suicide, and often drug overdoses. Whether your policy is governed by ERISA (federal law for employer-sponsored plans, with a mandatory appeals process and focus on "reasonable expectations," employing either a two part test or a substantial certainty test) or state law (which varies, with California focusing on unforeseen events and other states relying on policy language), insurance companies may dispute claims. Dorian Law P.C. understands these complexities, including the specific laws in your region, and will fight to secure the AD&D benefits you deserve. Contact us today for a consultation if your claim has been denied.
Understanding State Bans on Discretionary Clauses in Insurance Policies
Facing an Unfair Insurance Claim Denial? Did you know your insurance company might have the final say on your claim, even if it seems unjust? This power comes from "discretionary clauses" hidden in some insurance policies, allowing insurers to interpret the rules in their favor. This can be a major hurdle, especially in long-term disability, life insurance, and AD&D claims, often governed by ERISA. While many states are banning these clauses to protect policyholders, there's a catch for those in self-funded ERISA plans. These plans often aren't subject to state insurance regulations, meaning discretionary clauses could still impact your claim.