On December 19, 2012, Jay Bradford, the Arkansas Insurance Commissioner, approved Insurance regulation or Rule 101. Rule 101 prohibits discretionary causes in long term disability policies issued in Arkansas effective March 1, 2013.
The stated purpose of Rule 101 is to eliminate conflicts of interest for insurers who are responsible for both deciding and paying claims.
Rule 101 is a step in the right direction and should prove helpful for claimants of private disability insurance benefits. These claims are commonly referred to as ERISA claims because the policies are usually purchased through an employer and come under federal ERISA jurisdiction.
As always, don’t wait until the last minute to hire an attorney to appeal a denial. Once the administrative appeal process ends it’s very difficult to supplement the evidence in a claim file.
Most denial letters provide 180 days to send a written appeal. Generally, all administrative remedies must be exhausted prior to filing a law suit. Hire a local lawyer sooner than later.