MetLife Pays Over $200 Million in Regulatory Investigation Over Pension Benefits

A common issue with life insurance benefits is a deceptively simple one: what if the beneficiary doesn't know that they are named in the life insurance policy?  In such cases, life insurers are typically obligated to advise the unknowing beneficiary of the insured's death and their entitlement to death benefits under the insurance policy.  But …

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Four Common Disability Insurance Provisions and Why They Matter

As with most insurance cases, disputes over disability insurance coverage or benefits frequently turn on the specific insurance policy language at issue.  Insurance policy fine print can often be read in ways that are counterintuitive.  Below are four common policy provisions that are often key to the outcome of disability insurance disputes. 1.     The Definition …

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Aetna Fined Over Autism And Substance Abuse Coverage

State regulators in Pennsylvania fined health insurer Aetna  this week, for violating rules on coverage of drug and alcohol abuse treatment and coverage of autism spectrum disorder. A federal law called the Mental Health Parity and Addiction Equity Act generally forbids health carriers from discriminating against coverage for mental health conditions or substance abuse disorders.  …

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Happy New Year – Washington Health Insurers Are Now Required to Expand Contraceptive Coverage

In 2019, Washington health insurers are required to expand contraceptive coverage. Any health plan in Washington issued or renewed on or after Jan. 1 must now provide coverage for the following: All FDA-approved contraceptives, including drugs and devices; and Voluntary sterilization procedures. The new law also requires coverage for consultations, examinations and procedures necessary to obtain …

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Court Ruling Emphasizes Common Sense Reading of Insurance Policy in Win for Policyholder

The Washington Court of Appeals recently decided Poole v. State Farm Fire and Casualty Company, a case about fine print in a homeowner's policy.  After the Pooles' home burned down, State Farm denied coverage under a technical reading of the words "similar construction."  Washington's Court of Appeals disagreed with State Farm and emphasized the traditional …

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