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What Does a Vocational Expert Do?

Fri Aug 24th, 2018 on     Insurance Claims,    

Though vocational experts are perhaps more well-known for their role in Social Security disputes, they also play a critical role in private disability benefits disputes — as such, it is important to understand how to use vocational experts to your advantage (and how to undermine the testimony of opposing vocational experts) for the purpose of strengthening your benefits claim. Vocational Experts and Disability Insurance Disputes Vocational experts have a very specific role in the disability […]

How Mediation Can Help Insurers and Claimants Resolve Their Dispute

Fri Aug 17th, 2018 on     Disability Insurance,    

In Florida, and throughout the country, mediation of complex insurance disputes (whether a disability insurance dispute, health insurance dispute, or otherwise) is a common strategic option employed to resolve the conflict before litigation.  Through the mediation process, the involved parties — insurer and policyholder — can negotiate a favorable settlement that satisfies their expectations while avoiding the hassles and difficulties typically associated with insurance litigation. Litigation May Be Fraught With Difficulties Litigation can be somewhat […]

What Are Residual Disability Benefits?

Fri Aug 10th, 2018 on     Disability Insurance,    

Residual disability benefits are common, in Florida and throughout the country — whether in the form of an insurance rider on a total coverage plan, or as a standalone income replacement policy — as a means with which to ensure that the claimant can secure at least some benefits after suffering a disabling event that is not necessarily catastrophic. For example, if you are injured in a car accident, then you may suffer a disability […]

How Benefits for Psychiatric Conditions Can Be Limited

Tue Jul 31st, 2018 on     Disability Insurance,    

Disability insurance coverage can surprise many policyholders who put too much trust in their insurer to “do right” by them.  All too often, disability insurance policyholders believe that they are well-protected by their private policy, only to find that their insurer is taking steps to avoid or minimize the payout altogether. In many cases, the insurance contract itself includes language that could expose the policyholder to a dispute down the line, when they have actually […]

Adverse Benefit Determinations Under ERISA

Tue Jul 24th, 2018 on     Insurance Claims,    

The Employee Retirement Income Security Act (ERISA) established certain standards for qualifying plans — more specifically, for private employee benefit plans — that are intended to protect employee-claimants from abuse, mismanagement, and various other concerns commonly encountered in the insurance dispute context.  Over the years, ERISA has been expanded quite substantially.  If your insurance plan is governed by ERISA regulation, you may be entitled to notification and the opportunity to appeal an adverse decision relating […]

Countering an Insurance Denial for a Lapsed Policy

Tue Jul 17th, 2018 on     Insurance Claims,    

Oftentimes — in Florida and elsewhere — insurers will deny otherwise legitimate claims due to the coverage having lapsed.  Insurance coverage will lapse when the claimant has failed to make a premium payment before the applicable due date.  This applies to all types of insurance coverage, from disability insurance to health insurance to property insurance, and more.  If the coverage lapsed before the events giving rise to the claim (i.e., an accident that renders you […]

Disability Insurers May Offer to Buyout Claimants

Tue Jul 10th, 2018 on     Disability Insurance,    

Disability claimants may be surprised to find that — despite the fact that they have never lapsed on insurance payments and are submitting a reasonable disability benefits claim — the insurer response is unaccommodating.  Disability insurers employ a number of questionable tactics in order to force the claimant into a vulnerable position.  For example, if you have been rendered permanently disabled due to a degenerative condition, the insurer may deny your claim, delay your claim, […]

How Are ERISA-Covered Plans Different Than Standard Plans?

Fri Jun 29th, 2018 on     Disability Insurance,    

In 1974, the Employee Retirement Income Security Act (ERISA) was enacted, thus creating new standards governing private employee benefit plans — such as employer-sponsored disability, health, and welfare insurance, among other plans.  In Florida and elsewhere, ERISA does not require that employers purchase private insurance coverage for their employees, but it does impose a stricter set of rules on such plans so that employee-policyholders are protected from the potential abuses of plan administrators and others. […]

Common Liability Insurance Exclusions

Fri Jun 22nd, 2018 on     Insurance Law,    

Most businesses in Florida and elsewhere purchase some form of commercial general liability (CGL) insurance coverage so as to avoid the potentially disruptive effect of a personal injury lawsuit brought against the business. For example, a small retail business with few assets may only have enough funds to cover costs — if a customer slips-and-falls on the premises, and thus severely injures themselves, then the ensuing lawsuit could seriously disrupt (and even bankrupt) the business. […]

Four Ver Ploeg & Marino Attorneys Named Florida Super Lawyers For 2018 And Five Honored As Rising Stars

Tue Jun 19th, 2018 on     Uncategorized,    

MIAMI, FL —Ver Ploeg & Marino is pleased to announce that four of its attorneys have been selected to the 2018 Florida Super Lawyers list for the Insurance Coverage practice area. They are Brenton N. Ver Ploeg, R. Hugh Lumpkin and Stephen A. Marino, Jr., all shareholders in the Miami office, and Robert P. Major, of counsel in the firm’s Orlando office.  No more than five percent of the attorneys in the state are selected […]

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