Personal Injury

Exclusions, Limitations, and Offsets Oh My!: Is the Total Value of Your Disability Insurance Benefits At Risk?*

February 27, 2023 | by Mehr Fairbanks Trial Lawyers

Disability insurance is a unique type of insurance that protects a person’s ability to earn a paycheck if that person experiences a serious injury or illness. Disability insurance is meant to provide employees with a way to receive a portion of their expected income if they later become unable to work. Disability insurance is often categorized as either short-term or long-term. The primary difference between short-term and long-term disability plans are the periods of time a person may receive benefits due to her inability to work. Short-term disability plans usually work in tandem with long-term disability plans. Generally, once short-term benefits are exhausted, then a long-term disability policy would become effective in an effort to continue providing an employee with income until she is able to return to work. Some long-term disability plans may last for the lifetime of the policyholder, most will usually provide coverage for approximately thirty-six (36) months.

Most employers provide some type of disability insurance coverage for their employees. It might be time to refresh your memory on what your employer provides you with specifically. In an unpublished opinion, the Ninth Circuit recently determined that an employer provided disability insurance company was within its rights to reduce an employee’s disability benefits by $800,000. The $800,000 came from a recent personal injury settlement the employee received on a completely unrelated matter. Haddad v. SMG Long Term Disability Plan, No. 16-CV-01700-WHO, 2021 WL 2187979 (E.D. Cal. May 28, 2021).

The case turned on the legal distinction between “offsets” and “exclusions” and “limitations” in regard to long-term disability plans. This marginal difference may be the difference between receiving the anticipated total value of long-term disability benefits or having that total value later diminished. Exclusions and limitations carve out areas from the scope of an insurance policy’s coverage. Offsets reduce the total amount owed for covered claims.

Court Certifies ERISA Class Action Against Aetna

June 3, 2022 | by Mehr Fairbanks Trial Lawyers

A federal court in Pennsylvania recently certified a class of Plaintiffs under Defendant Aetna Life Insurance Co.’s disability benefits plan (“Plan”). The Plaintiffs alleged that the Defendants forced beneficiaries who had received payments for personal injury claims to send the payments back to the company in violation of ERISA.

The named Plaintiff, Joanne Wolff, first filed suit against Aetna in 2019 when the company asked for the repayment of over $50,000 in long-term disability benefits stemming from a temporary disability suffered by the Plaintiff after a car wreck. At the time of the request, Wolff told the Defendants that her employer, Bank of America, did not allow reimbursement, and negotiations ended in an agreement that that Wolff would pay $30,000 despite this fact.

This did not end the dispute, however, and Wolff along with an at least 48-member class now allege that Aetna violated ERISA when it required reimbursement payments of long-term personal injury disability payments. Aetna responded that class certification would be inappropriate, as the proposed class did not meet the specifications required for certification under the Federal Rules of Civil Procedure. Mainly, the Defendants argued that some of the members of the proposed class should be disqualified, thus the number of participants in the class did not meet the numerosity requirement. It argued that since some of the members of the class were from different companies, there was not sufficient typicality to fulfill the requirements under the Civil Rules and members under other employers should be disqualified, reducing the class number to 28. Aetna also argued that timing issues barred several more participants under the relevant statutes of limitations.

Mehr Fairbanks Trial Lawyers Receives a $345,000 Jury Verdict

May 26, 2022 | by Mehr Fairbanks Trial Lawyers

Late Wednesday evening, May 25, 2022, Mehr Fairbanks Trial Lawyers’ Attorney Bartley Hagerman received a $345,000 jury verdict in a motor vehicle accident trial in Woodford County, KY. The 3-day trial was against the at-fault driver and the plaintiff’s underinsured motorist (UIM) carrier. More details will be posted soon!

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Frequently Asked Questions (FAQs) on Accidents

December 17, 2019 | by Mehr Fairbanks Trial Lawyers

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The accident attorneys at Mehr Fairbanks Trial Lawyers frequently represent people who have been injured in accidents. Car wrecks, medical mishaps, and falls can frequently devastate a family. In those circumstances, the injured party has a right to sue the negligent person or company. The injured party can recover medical expenses, lost wages, damage to future earning capacity, and pain and suffering damages.

Below are some frequently asked questions regarding accidents. If you have further questions or you’ve recently been injured in an accident, contact one of our experienced personal injury attorneys for a free consultation today.

What compensation can I receive if I’ve been in a car accident? If you are in a car accident caused by someone else, you could recover damages in the form of lost wages, out-of-pocket expenses, damage to your property, medical expenses, and pain and suffering. Even if the accident is your fault, you may have insurance coverage for the damages you sustain.
What if I’m in a car accident without insurance? If someone without insurance causes an accident involving you, you could have a claim under your own insurance under uninsured motorist coverage, if you elected this coverage.
Can I receive compensation if I’ve been in a motorcycle accident? If you are a motorcycle rider and are in an accident caused by someone else, you are entitled to damages just as if you were in a car. This can include lost wages, out-of-pocket expenses, damage to your property, medical expenses, and pain and suffering.
What if I’m in a motorcycle accident without insurance? If someone without insurance causes an accident involving you, you could have a claim under your own insurance under uninsured motorist coverage, if you elected this coverage.
Can I receive compensation if I’ve been in a truck accident? If you are in a truck accident caused by someone else, you could recover damages in the form of lost wages, out-of-pocket expenses, damage to your property, medical expenses, and pain and suffering. Even if the accident is your fault, you may have insurance coverage for the damages you sustain.
What if I’m in a truck accident without insurance? If someone without insurance causes an accident involving you, you could have a claim under your own insurance under uninsured motorist coverage, if you elected this coverage.
How does the criminal or traffic case relate to a personal injury claim or lawsuit? A criminal or traffic charge can impact a civil suit for personal injury. If the crime or traffic charge arises out of the same facts and circumstances which create civil liability, a conviction or guilty plea on such charges can be used against the offender in a civil proceeding. But, being found not guilty of criminal charges or traffic violations does not absolve the offender of liability for damages caused to another in a civil proceeding. They are different standards.
Can I obtain the cell phone records of the driver? Cell phone records can typically be obtained by subpoena to the cell service provider. Those records are not confidential or protected from the subpoena powers of the court, and the records can be used against you.
How can I prove the other driver was responsible? Lawyers skilled in personal injury actions arising from a motor vehicle incident use various tools and techniques to establish the liability of the driver causing the damages. These can rely on many sources of evidence including witness testimony, video camera footage, accident reconstruction, and expert witness testimony.