Question
Using the policy date to cancel disability benefits 3.5 months premature to insureds 65th birthday
I was receiving disability benefits which were suddenly and without any warning cancelled 3.5 months before my 65th birthday. The policy clearly states benefits payable "TO AGE 65". Their argument: The policy benefits expired on the anniversary date of the policy by stating that Donna was 65 years old on December 20, 2022 instead of her actual birthday of March 4, 2023. I won the case in small claims. The insurance company appealed and has hired Misty Murray at MaynardNexsen to handle the appeal. Is this a precedent setting case and that is why Davis Third party administrators are willing to spend more to defend than the value of the case? Is Davis TPA using this tactic to deny benefits to other insureds on claim?
I am sharing this information with you as a service to you and others who may have larger value cases as I suspect that I am not the only one.
I am sharing this information with you as a service to you and others who may have larger value cases as I suspect that I am not the only one.
Answer
Donna, thank you for reaching out to us and bringing this to our attention. Common sense dictates that the language of the governing policy will govern this situation and that it would be pretty straightforward, however, some of the policies are not well written, which may be the issue here. Is there any chance that you can send us a copy of the governing policy, the small claims court decision, and the appeal? My guess is that the small claims court did not have jurisdiction to decide this issue, but I could be wrong. We look forward to hearing from you.
