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Divernan

(15,480 posts)
43. The agent was relaying the fact of life that policy rates increase for higher risks.
Sat Apr 19, 2014, 12:52 AM
Apr 2014

The ADA prohibits businesses from discriminating in the work place, but I don't believe it applies to firing an employee who becomes too ill to work at all. That's why individuals and/or employers can purchase short-term and/or long-term disability insurance; and/or put in a claim for SSDI with the govt. And re that type of insurance, my daughter was on 18 month disability leave for a major case of Lyme's disease. Her short-term carrier paid up with no questions. But when she'd exhausted the time limits for short-term and made a claim to the different insurance carrier which handled long-term coverage, she was summarily turned down and we had to find an attorney who specializes in disability cases. Because the policy was provided by her employer as a work benefit, and not purchased by her individually, it comes under ERISA, and all cases must go to federal court for non-jury (bench) trials.

Turns out her carrier, Liberty Mutual, denies ALL long term disability claims, and forces insureds to sue them in federal court. And Liberty Mutual delay doing that as long as possible by filing documents at the last possible moment, getting months long extensions from the courts, "losing" records sent by the plaintiff's doctors, - every damn trick in the book to stall and delay.

The federal judges heartily dislike these cases because, without juries, the judges are the finders of fact and have to wade through volumes of medical reports, expert reports, etc. Consequently, at least in our federal district court in Pennsylvania, the judges put so much pressure on the parties to mediate/settle that no recent cases have gone to trial. I asked the attorney what kind of settlements were reached, and he said about 20 cents on the dollar. And it takes years to finally receive any payments. Every time I see one of those warm and fuzzy Liberty Mutual ads on tv, I want to hurl.

On edit: FYI, I'm a retired attorney who used to handle insurance cases for property damage/personal injury - but NOT disability claims - that's a specialty, which is why I found an atty. for my daughter to handle her case. So I understand general principles of insurance law, at least as it was up until the time I retired. However, the law is always changing, either by legislation of new/amended statutes or by appellate decisions. Your employee should have applied for social security disability.

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after a few years arely staircase Apr 2014 #1
Exactly. mahina Apr 2014 #2
I can't find it, but there is a Spanish proverb about the war of the day and the night. freshwest Apr 2014 #11
That is one of the reasons the CBO estimate is showing a long-term lowering of medical costs. A lot okaawhatever Apr 2014 #6
that makes sense arely staircase Apr 2014 #9
In MA, health care bankruptcies are still 50% of the total eridani Apr 2014 #31
Cool, Now fire your insurance man instead. Nobel_Twaddle_III Apr 2014 #3
THIS^ OffWithTheirHeads Apr 2014 #10
You bet! ChairmanAgnostic Apr 2014 #30
Exactly what I was going to say! Initech Apr 2014 #49
There are only three age categories, so maybe that won't hit you as badly as you think -- pnwmom Apr 2014 #4
Honestly? mahina Apr 2014 #5
I just gave money to a man on the street the other day Egnever Apr 2014 #7
I find I'm experiencing coincidences like that all the time. mahina Apr 2014 #8
I hope you got a new agent? newthinking Apr 2014 #12
It's not the agent, it's the insurance company. Divernan Apr 2014 #42
Yes, but to even suggest firing somebody....? newthinking Apr 2014 #46
I just watched "Capitalism- A Love Story" by Micheal Moore" deathrind Apr 2014 #13
Mahalo, I'll put it in my queue. mahina Apr 2014 #14
Corporations are people, my friend! King_Klonopin Apr 2014 #15
But not this one. mahina Apr 2014 #16
I was referring to the Health Insurance Co. (I should have been more explicit) sorry. n/t King_Klonopin Apr 2014 #17
Not a worry for a second, I took your point exactly. mahina Apr 2014 #18
"I really can not think of a more devious/evil thing to do." Enthusiast Apr 2014 #23
I recall a case from the 1970's HeiressofBickworth Apr 2014 #19
similar happened to a friend just a few years ago catrose Apr 2014 #27
Please, please, tell me that employer was subsequently run-over by a truck nikto Apr 2014 #36
Me too. I'll settle for a Ric Shaw. RagAss Apr 2014 #40
Sorry to have to burst your bubble HeiressofBickworth Apr 2014 #47
Thanks for the truth... nikto Apr 2014 #48
Hugs to you, Mahina. This is a story that should go out as a LTTE, copied to... Hekate Apr 2014 #20
Aloha no Hekate! mahina Apr 2014 #21
Thank you for what you did oldandhappy Apr 2014 #22
I'm glad I wasn't there. DeSwiss Apr 2014 #24
Something like that. mahina Apr 2014 #25
Do you have what they suggested in writing? Exposethefrauds Apr 2014 #26
Was that HMSA, by any chance? KamaAina Apr 2014 #28
You are a wonderful human being ashling Apr 2014 #29
+1 Liberal_in_LA Apr 2014 #32
Thank You.. Stuart G Apr 2014 #33
Your insurance agent urged you to break the law? Not ACA, but the ADA. DRoseDARs Apr 2014 #34
Mahalo for that info. mahina Apr 2014 #38
The agent was relaying the fact of life that policy rates increase for higher risks. Divernan Apr 2014 #43
YOU defied a Death-Panel, dude! nikto Apr 2014 #35
This is what America needs to be. 99Forever Apr 2014 #37
Thanks for your kindness but I'm not bringing this up to say how good we are, mahina Apr 2014 #39
Understood. 99Forever Apr 2014 #41
k&r.... thank you for saving this employee spanone Apr 2014 #44
Mahina - just for the heck of it Iwillnevergiveup Apr 2014 #45
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