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In walks our government. With all due respect, most Americans know that Social Security is a tax we all pay, but the politicians have borrowed from it and it is destined to be bankrupt by 2019, if not sooner. Not a good scenario for the average American, the blue collar worker and our teachers. We are still paying, but the money may not be there when we are supposed to get our payback. We are all paying into the system but the system has a fault line that could swallow us all.
A dilemma is brewing in Pennsylvania that is about to develop into a full-blown tragedy for 144,000 unsuspecting Conseco long term care policyholders. Without any notice or warning to these faithful, premium-paying senior citizens, Conseco has proposed creating a new Senior Health Insurance trust to uncouple a hemorrhaging block of business it purchased from American Travelers and Transport Life in the mid-1990s. By Frank N. Darras
Shernoff Bidart Darras
We have come a long way since the oversold and underpriced, overgenerous language of the ’70s and ’80s, where everybody got more than they could use. Subsequently, we endured the crash and burn of the ’80s and ’90s, with “scorch the earth” mentality and lawsuits stacked up upon denied policyholders. We have finally turned the corner in the disability market — realizing profitability along with unprecedented changes and new claim objectives.
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By Frank N. Darras, Nation’s Leading Disability, LTC and Life Expert
Shernoff Bidart Darras
No doubt about it — Americans are getting older. Today, more than 34 million people are over the age of 65. By the year 2010, this number will grow to 40 million. By the year 2010, this number will grow to 40 million.
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By Frank N. Darras
Shernoff Bidart Darras
In recent years there has been a proliferation of bad-faith lawsuits against disability insurers resulting in tens of millions of dollars in jury awards. For example, in May 2001 a Florida jury awarded $36.7 million to an eye surgeon whose claim was denied even though Parkinson’s disease made his hands tremble. In February 2002, a California judge upheld a $7.67 million jury award (including $5 million in punitive damages) to a former chiropractor and sternly warned the insurer against future violations. And in January 2003, a California jury awarded $31.7 million (including $30 million in punitive damages) to another eye surgeon. Although the verdict was reduced to $6.1 million, the judge rebuked the insurer for the “creation of a claims-handling procedure that appears designed to avoid performing a thorough, competent and objective investigation of a plaintiff’s claim.”
Read more... By Frank N. Darras
Shernoff Bidart Darras
Many policies require that the injury, death or disability for which a claim is being made occur within a specified period of the occurrence of the accident — usually 90 days — to assure that the loss was in fact proximately caused by the accident. Some jurisdictions apply the “process of nature” rule to lessen the harshness of requiring that disability occur immediately or within a specified number of days after an accident.
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Disability insurers argue that insureds have dual occupations and are not totally disabled under the policy because they can perform another job. An insurer may argue that a self-employed physician is not only a physician, but also a business owner that he still can run his medical business and thus is not totally disabled.
By Frank N. Darras
Shernoff Bidart Darras
Own-occupation disability policies generally provide that insureds are totally disabled — and entitled to benefits — if they are unable to perform the substantial and material duties of their occupation due to injury or illness. An insured’s occupation is usually defined as the occupation in which he or she was regularly engaged at the time of disability. Thus, under an “own-occ” policy, if a surgeon can no longer perform surgery, the policyholder is entitled to disability benefits — even if that person can still make a living as a doctor.
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