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Understanding Disability

Adjusters and claim handlers who deal with disability claims may have to rethink some of the previous standards for what constitutes a “disability."

By Ken Brownlee, CPCU | Updated on June 29, 2011

Considering that AFLAC’s duck acquired a new voice this past spring, adjusters and claim handlers who deal with disability claims, whether under disability insurance policies, workers’ compensation, or liability for bodily injuries, may have to rethink some of the previous standards for what constitutes a “disability” and whether the duck will come to the rescue. In fact, the adjuster may be that duck.

Definitions of disability differ by jurisdiction, and what is true in one state or federal district for a particular type of insurance case may not necessarily be true in another. However, a recent 7th U.S. Circuit Court of Appeals decision may have a serious impact on what constitutes a claimable disability when there is no “objective proof” or evidence of an injury. The case, Holmstrom v. Metropolitan Life Ins. Co. (615 F.3d 758 [7th Cir., 2010]), falls under the Employee Retirement Income Security Act (ERISA) in the Seventh Circuit, but may become precedent for other jurisdictions and types of claims as well.

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