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Life Health > Health Insurance > Your Practice

Court Says Insurer Can't Cut Veteran's Disability (Businessweek)

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A 3-judge panel at the 8th U.S. Circuit Court of Appeals has thrown out a lower-cut ruling involving a long-term disability (LTD) insurer’s effort to coordinate the LTD benefits with veterans’ benefits.

James Riley, 56, was receiving veterans’ benefits because of multiple sclerosis symptoms that developed in the early 1970s, while he was serving in Vietnam, according to Margery A. Beck of BusinessWeek.

He later was working and had on-the-job LTD benefits from Sun Life and Health Insurance Company. He stopped working and filed an LTD claim in 2005.

When Sun Life realized it was paying benefits for a disease that had surfaced years earlier, it reduced benefits payments and said Riley should repay about $21,000.

A district court judge ruled in favor of Sun Life, which said an LTC policy provision provided that its monthly payments could be reduced by “other income” including Social Security payments, Railroad Retirement Act payments or payments under “any other similar act or law provided in any jurisdiction.”

The 3-judge panel found that the Veterans Benefits Act is different from the Social Security and Railroad Retirement acts.

Read the story.


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