[{"@context":"https:\/\/schema.org\/","@type":"BlogPosting","@id":"https:\/\/www.rizklaw.com\/blog\/long-term-disability-reimbursement-claims\/#BlogPosting","mainEntityOfPage":"https:\/\/www.rizklaw.com\/blog\/long-term-disability-reimbursement-claims\/","headline":"Long Term Disability Reimbursement Claims","name":"Long Term Disability Reimbursement Claims","description":"You have a long term disability claim. But now the Long Term Disability Carrier or disability \u201cPlan\u201d seeks to recover from you outstanding medical costs\u2026 costs your disability insurer never fully paid in the first place. On January 16, 2011 the United States District Court sitting in Seattle will hear, for the first time, whether...","datePublished":"2010-12-07","dateModified":"2024-05-22","author":{"@type":"Person","@id":"https:\/\/www.rizklaw.com\/blog\/author\/rizklaw\/#Person","name":"Rizk Law","url":"https:\/\/www.rizklaw.com\/blog\/author\/rizklaw\/","identifier":9,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/10e23ce5e6c4dadb4589cd8edf2c3f59ac356a6e876c3656917777913d9c3bc1?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/10e23ce5e6c4dadb4589cd8edf2c3f59ac356a6e876c3656917777913d9c3bc1?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"Rizk Law","logo":{"@type":"ImageObject","@id":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/rizk-law-logo-footer.jpg","url":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/rizk-law-logo-footer.jpg","width":278,"height":65}},"image":{"@type":"ImageObject","@id":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/Richard-Rizk-headshot.jpg","url":"https:\/\/www.rizklaw.com\/wp-content\/uploads\/2024\/03\/Richard-Rizk-headshot.jpg","width":383,"height":427},"url":"https:\/\/www.rizklaw.com\/blog\/long-term-disability-reimbursement-claims\/","about":["Personal Injury"],"wordCount":348,"articleBody":"You have a long term disability claim. But now the Long Term Disability Carrier or disability \u201cPlan\u201d seeks to recover from you outstanding medical costs\u2026 costs your disability insurer never fully paid in the first place.On January 16, 2011 the United States District Court sitting in Seattle will hear, for the first time, whether such a claim against a disabled insured, is allowed under Section 502(a)(3) of the Employee Retirement Income Security Act (\u201cERISA\u201d). The Court will also determine whether the plan must pay its fair and proportional share of the fees and costs. These questions are unresolved in the Federal 9th\u00a0Circuit and will greatly impact millions of employees covered by self-funded ERISA plans. The case is\u00a0CGI technologies v. Rhonda Rose,\u00a0# CV 10 298 RSM.The most a disability insurance insurer should ever recover is the amount of medical expenses the disabled person recovered\u00a0and\u00a0the disability insurer in fact paid. In\u00a0CGI v. Rose, Ms. Rose only recovered 21.44% of her total damages. Thus, equity requires that the insurer\u2019s recovery be limited to 21.44% of covered medical expenses, less a proportional share of costs and attorneys\u2019 fees.In\u00a0Sereboff v. Mid Atlantic Medical Servs., Inc., 547 U.S. 356 (2006), the U.S. Supreme Court found that an ERISA reimbursement is allowed by ERISA. 547 U.S. at 368. What\u00a0Sereboff did\u00a0not address is:what is the\u00a0extent\u00a0of the insurer\u2019s reimbursement right from an injured beneficiary?Long term disability insurers should not always be entitled to recover whatever relief the insurance plans says. Instead, disability insurer recovery rights should be limited to what is equitable. In no circumstances should a disability insurer be allowed to recover from a disabled person amounts the disabled person did not recover in the first place or the long term disability insurer did not fully pay for.ERISA is widely known as pro-insurer law with respect to reimbursement rights. Write you US Senator or Congressman today to request support for a bill limiting insurer recovery to amounts the disabled person actually received and requiring the insurer to pay its prorate share of costs and attorney fees."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Blog","item":"https:\/\/www.rizklaw.com\/blog\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Long Term Disability Reimbursement Claims","item":"https:\/\/www.rizklaw.com\/blog\/long-term-disability-reimbursement-claims\/#breadcrumbitem"}]}]