The IQ: ICA Quarterly was created to be the online newsletter of choice for professionals in the claims industry. Through a blog format, we hope to provide a venue for ICA members to share information including success stories, breaking industry news, and updates on activities of the ICA leadership. We believe this new format will help our community prepare for the future by sharing ideas and best practices and encourage you, as ICA members, to submit content as part of your own professional development.
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“So, how long do you need to be off work?” This was the question posed to me by the urgent care physician following a brief examination and discussion of my back pain symptoms.
Chronic pain has been estimated to affect more than 100 million people in the United States and is the reason for about one in five office visits to a physician.1 Chronic pain is often accompanied by psychological problems, especially depression, and frequently has an adverse impact on the occupational and social lives of those affected.
This matter originated out of a challenge by Plaintiff of the termination of his disability benefits under his Company’s ERISA Plan. The District Court granted the insurer’s motion for summary judgment – based upon an abuse of discretion standard of review – from which Plaintiff appealed.
The Tax Cut and Jobs Act requires taxpayer disclosures and IRS returns in connection with Reportable Policy Sales.
Amy Van Dyken is a 6-time Olympic gold medal champion swimmer who made history as the most successful athlete at the ’96 Summer Olympics in Atlanta, Georgia and the first American female athlete to win four gold medals in a single Olympic games.
The ICA is pleased to welcome Linda Pierre, Conference Manager and Andrew Bird, Director of Operations, as the newest additions to headquarters staff.
June is a time when the temperatures rise, days grow longer and according to custom, it becomes acceptable to wear white pants again. Additionally, there is a lesser known but equally important event that occurs each June: the opening of registration for the International Claim Association’s Annual Education Conference.
The International Claims Association has been dedicated to partnering with law enforcement to supply pertinent policy information in the course of criminal investigations that may have a financial etiology since 1999. As the Law Enforcement Inquiry Director (aka volunteer) I receive numerous inquiries from local, state, and federal law enforcement on a weekly basis asking for our members to assist them in looking for potential life insurance/annuity policy information that may be a critical turning point in their investigation.
Understanding and obtaining a claimant’s occupational duties and job functions are vital to claims adjudication and making the appropriate decision regarding the approval, or rejection of a disability claim. Assessing a claimant’s occupational duties, relevant worker characteristics, and day-to-day pre-disability job demands are essential factors in this determination. In fact, understanding the material and substantial duties of this occupation is at the very core of claims management in today’s environment.
The exclusion from accident coverage for loss contributed to by illness will only apply if the disease “substantially contributed” to the loss.
Disability claims based on multiple sclerosis or “MS” are challenging. An insurer must consider the claimant’s subjective symptoms and the medical evidence when assessing whether an insured’s functional capacity prevents him or her from performing occupational duties. The recent unpublished ERISA decision out of the Ninth Circuit – Kibel v. Aetna Life Insurance Company, __ Fed.Appx.__, 2018 WL 832870 (9th Cir. Feb. 13, 2018) – implies that an insured’s return-to-work efforts and subjective evidence should play a more significant role in an insurer’s analysis of an MS claim. However, careful scrutiny of the evidence not discussed by the Court suggests that it may simply have been looking for a way to award further benefits.