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long term disability was a loan not insurance Oregon

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  • long term disability was a loan not insurance Oregon

    My wife received LTD payments from a Portland Insurance company until she started getting SSD. Now Standard Insurance is demanding an $9,000 refund. Her employer was paying the premium for this coverage but she was never told that she wasn't truly "insured". I say that because any repayment makes it a LOAN. If she had known the truth she could have signed up with a different carrier or AFLAC. We threatened to sue for breach of contract and was told if we made waves they would "re-evaluate" her claim and may find that she "doesn't qualify" as disabled (stated in a letter). About 6 different doctors say she is totally disabled. Do we ave a federal ERISA claim?

  • #2
    Not at all. You calling it a loan does not make it so.

    It is very, very common and very legal for there to be an offset of benefits when SSDI kicks in. Read the policy.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      Agree - otherwise, it would be like she was getting paid twice. Do read the policy though as suggested.
      Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Leo Buscaglia

      Live in peace with animals. Animals bring love to our hearts and warmth to our souls.

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      • #4
        That may be true, but who's business is it?

        Originally posted by Betty3 View Post
        Agree - otherwise, it would be like she was getting paid twice. Do read the policy though as suggested.
        If she gets LTD is a part of her benifits package, (that thing you agree to, to give up your freedom for) it should not come with strings attached.
        IE 1) you only get it if your total household income is less than $30k, 2) you only get it if your single, 3) you only get it if your between 15~18 yrs old. 3) you only get it if you DO NOT have other insurance like AFFLAC or SSD. 4) you only get it if your name is Rockafeller. 5) you only get it if your HIV positive. Where does it stop?
        She was not informed, was not given a chance to examine and then look for alternative coverage!

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        • #5
          It's the business of the people who are writing checks with her name on them.
          The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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          • #6
            She was not informed, was not given a chance to examine and then look for alternative coverage
            If she wasn't fully aware of the provisions, maybe she shouldn't have enrolled in this plan to the exclusion of all others.
            I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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