A federal court in Utah has ruled that a long-term disability insurance company that tried to limit benefits to 12 months for a "chronic pain and fatigue-related illness" was wrong. The insurance company contended that so long as the primary disabling symptoms of an illness were pain and fatigue, the limitation applied.
In this case, however, the pain and fatigue were caused by another disabling diagnosis. The court found that the insurance company's interpretation of its policy was wrong as it would limit benefits for just about any condition that also caused chronic pain and/or fatigue. Since pain or fatigue are the result of many conditions, this would make the policy benefits illusory.
Long-term disability claim tips:
- Whenever a disability insurance company denies or limits a claim based upon a policy provision, the claimant should have the denial reviewed by an experienced long-term disability attorney.
- An experienced attorney will be in the best position to advise as to how this specific language has been interpreted across the country.
- Disability insurance companies know that for every ten denial letters they send out only one person will make their way to an experienced disability attorney. Thus they save money by sending out lots of denial letters.