Glossary
De Novo Review
This is a standard of review that is often applied in cases governed by ERISA, if the policy at issue does not contain a discretionary clause. This standard of review is much more favorable than abuse of discretion review, because, under de novo review, the court is permitted to independently review your claim and is not required to grant the insurer’s decision any deference.
Click here for more information about when a de novo standard of review is applied.
Degenerative Disc Disease
A term used to describe changes to the discs of the spine that cause pain and discomfort, often including weakness, numbness, and tingling in the extremities. This condition is particularly common with dentists, due to the repetitive motions and static postures required by the profession.
Click here for more information about the prevalence of degenerative disc disease among dentists.
Denial of Benefits
Disability insurance claims are different from many other types of insurance claims because they are evaluated on an ongoing (typically month-to-month) basis. Consequently, even if a claim is initially approved, disability insurers can (and do) deny claims after previously paying several months of benefits.
Click here for more information about what to do if your disability benefits are denied or terminated.
Disability Buyout Insurance
This type of insurance policy provides benefits that a business or practice can use to buy out the shares of a co-owner or shareholder who becomes disabled.
Click here for more information about disability buyout policies.
Disability Insurance
Disability insurance is a type of insurance that pays the insured a monthly benefit if the insured is no longer able to work, due to an injury/accident or a sickness.
Click here for more information about the most common mistakes professionals make when it comes to the disability insurance claims process.
Discretionary Clause
Discretionary clauses grant insurers broad discretionary authority to interpret your policy and determine your eligibility for disability benefits. If your disability policy contains a discretionary clause and your disability claim is denied or terminated, courts will generally be reluctant to overturn the denial/termination.
Click here for more information about discretionary clauses.
Dual Occupation Defense
When a professional that owns his or her own business files a disability insurance claim, the insurer will often try to exploit the claimant’s ownership status to deny total disability benefits. For example, the insurer might argue that an insured is both a clinical dentist and a business owner. The insurer will then argue that the insured is not actually disabled because he or she can still perform administrative or managerial functions, even if the insured cannot perform the duties of clinical dentistry. This is sometimes referred to as the “dual occupation defense.”
Click here for more information about how an insurer may attempt to use a dual occupation defense.
