Filing a disability claim after employment terminates?

[Toller]

My daughter in law was in an auto accident in a rental car while out of town on company business. It was entirely not her fault. She suffered traumatic brain injury, but it didn't become evident until months after the accident. She left her job in the interim. She had disability insurance at her job, but they are telling her that it does not cover her because she left her job before the disability became evident. Her neurologist says it is "likely" that the accident caused it.

It seems to me that if the injury occurred while employed it deserves coverage, especially since she was on company business when it happened.

I realize that what seems to me is irrelevant, but I wonder what the truth is on this. I also realize that she should see a disability lawyer about this, but I really hate to put her through that if it is pointless; she is going through enough.

 

[fed up]

Is her claim closed with the carrier of the At Fault party? If not put them on notice ASAP, then lawyer up.

 

[leevena]

My daughter in law was in an auto accident in a rental car while out of town on company business. It was entirely not her fault. She suffered traumatic brain injury, but it didn't become evident until months after the accident. She left her job in the interim. She had disability insurance at her job, but they are telling her that it does not cover her because she left her job before the disability became evident. Her neurologist says it is "likely" that the accident caused it.

It seems to me that if the injury occurred while employed it deserves coverage, especially since she was on company business when it happened.

I realize that what seems to me is irrelevant, but I wonder what the truth is on this. I also realize that she should see a disability lawyer about this, but I really hate to put her through that if it is pointless; she is going through enough.

There is insufficient information to give you a definitive answer, but I would strongly urge you to see an attorney for their evaluation, because there are a few moving parts that complicate the situation. Btw, I am not an attorney, I have been a benefits person for 37 years.

The key point here is that the physician states the accident “likely” caused the condition. The plan will not pay for “likely” and since she has left the job, the carrier is well within their rights to decline the claim.

Disability plans are usually written as off the job, meaning that if the cause was due to a job-related activity the plan will not cover it. There may be other sources of coverage for this due to the on-job component. Best of luck.

 

[Toller]

Her employer was in California, the accident was in Washington, and she lives in Wisconsin. The insurer offered her $2,000 and when she demanded $10,000 they told her to sue them. She had a heck of time finding a lawyer, but my lawyer had a classmate in Washington who has a partner that took it. He figures it may be a big case, but she won't get more than the $50,000 of insurance the guy had.

If she wants to discuss disability or workers comp with a lawyer, would that be the lawyer in Washington, or can she get a lawyer in Wisconsin? Dealing with a lawyer 1,500 miles away is awkward, but is required for the accident liability.

 

[Tahoe Ray]

Disability plans are usually written as off the job, meaning that if the cause was due to a job-related activity the plan will not cover it. There may be other sources of coverage for this due to the on-job component. Best of luck.

Most of the group DI that I run into is own occ and not subject to on/off job.

What type of coverage are you referencing?

 

[fed up]

Try not to demand in the future. That causes insurers to dig in their heels. You need a lawyer in California since the employer is in California