At the Defense Research Institute’s Life, Health, Disability and ERISA Conference in Chicago on April 3-5, 2019, Josh Lerner reviewed ways insurers and carriers can defend subjective disorder claims under disability insurance policies.

He talked about how courts in recent years have handled the discrepancy between the symptoms and complaints reported by the patient/insured and the lack of objective verification of the condition or the degree of disability, if any. “These cases involve conditions such as fibromyalgia, chronic pain, and chronic fatigue syndrome,” he explained. “Courts are trending toward recognizing these conditions, giving rise to both short and long term disability coverage,” added Lerner.

Reviewing several case results and their underlying facts, Lerner provided pointers for defending these claims. “Courts have criticized insurers for ignoring certain complaints and symptoms in favor of focusing on normal findings in the medical record,” noted Lerner.

One recommendation, “Hire truly ‘expert’ experts, meaning hire physicians and other experts who specialize in the particular condition at issue and who are at the forefront of their fields,” said Lerner.

Contact Josh Lerner to learn more about this or other issues concerning disability insurance coverage.