Insurance FAQ

What types of Insurance Claims and Lawsuits does Tucker & Ludin handle?

Disability Insurance (Short Term Disability and Long Term Disability)
Health Insurance
Life Insurance
Accidental Death & Dismemberment Insurance
Long Term Care Insurance

What is ERISA, and does it apply to all insurance policies?

"ERISA" stands for the Employee Retirement Income Security Act of 1974, a federal law passed by Congress to regulate all employee benefit plans. It covers nearly all employee benefits that people obtain through work.

Are there any employers that are not covered by ERISA?

Yes. ERISA does not apply to benefit plans offered to government or church workers.

How do I know if my insurance claims is covered by ERISA?

Your claim will be covered by ERISA if you got your insurance through your employer, and you do not work for a governmental entity or a church.

Why would I rather have individual insurance instead of insurance I can get through work?

Unlike insurance your purchase through work (which is governed by the federal law called ERISA), individual insurance policies are covered by state law. Having an individual insurance policy in Florida offers certain advantages, including:

In most situations, if you have to sue your insurance company, there is a law that makes the insurance company pay your attorney fees.
If you have to file a lawsuit against your insurance company, you will get a trial before a jury. For group plans covered by ERISA, you only get a Judge who will probably decide your case on written motions without a jury.
There are shorter deadlines for the insurance company to act on your claim.
Insurance companies may be subject to punitive damages for acting in bad faith.
In most cases, you are entitled to interest on unpaid benefits.

Where are individual insurance lawsuits filed - what court?

Most lawsuits involving first party benefits that are denied are filed in state court. The most common place to file them is in the County where your insurance was bought. In larger cases with a value over $75,000 and which involve an out-of-state insurance company, the case may end up in Federal Court.

If I file suit, does the insurance company have to pay my attorney fees and costs?

Yes, as a general rule, if you win an individual insurance case in Court, Florida law requires the judge to order the insurance company to pay your attorney fees and a portion of your out of pocket costs in most cases.

What kinds of illnesses or injuries can cause a disability?

Disability Attorney John Tucker has handled nearly 2000 disability claims, involving nearly every kind of illness or injury you can imagine. Our disability insurance team can help you prove your claim if your sickness or injury has impacted your ability to work. The following is a partial list of conditions that our clients have suffered from:
A

Affective disorders (like depression or anxiety)
AIDS & ARC

Allergic skin conditions
Amnesia
Amputation
Anal fissure
Anemia
Angina
Ankylosing spondylitis
Anxiety disorder
Arachnoiditis
Arrythmia
Artherosclerosis
Arthritis
Asthma

B

Bipolar disorder
Bladder control/cancer
Blindness

Bone fractures (particularly non-union)
Burns
Brain cancer
Brain malformation/cysts
Brain trauma
Breast cancer
Bulging disc

C

Cancer (many different types)
Cardiac arrythmia
Cardiac bypass
Cardiomyopathy
Carpal tunnel syndrome

Cataplexy
Cerebral atrophy
Cervical cancer
Cervical disc disease
Cervical degeneration

Cervical Dystonia
Chronic daily headache
Chronic fatigue syndrome

Colitis
Colon cancer
Colon disease (including spastic colon)
Cone-rod disorder
Congenital abnormalities (various)
Congestive heart failure

Connective tissue disease
Contracted peripheral vision
Coronary artery spasm
Crohn’s disease
Cushing’s Syndrome
Cystic fibrosis

Cystitis

D
Deep venous thrombosis
Degenerative disc disease
Dementia
Depression

Dermatitis
Diabetes
Dialysis

Drop foot

Dystonia

E

Encephalitis
Endometriosis
Epicondylitis
Epilepsy
Epstein-Barr Virus
Erosive Esophagitis
Essential Tremor
Eye Disorders and loss of eyesight

F

Facet arthritis
Failed back syndrome
Fibromyalgia
Foot drop
Fractures (particularly non-union)

G

Gastrointestinal reflux
GERD (gastroesophageal reflux disease)
Glaucoma
Graves disease

H

Headaches (including migraines)
Hemophilia
Hemorrhoids
Hearing impairment or loss (including tinnitus)
Heart disease
Heart failure
Hepatitis
Herniated disc
Herniated nucleus pulposus

Herpes Zoster (shingles)
High blood pressure & Hypertension
Hip replacement
Hodgkin’s disease
HIV
Hypertensive cardiovascular disease
Hypothyroidism

I

Incontinence
Infection
Insomnia
Intelligence Quotient (I.Q.) deficiency
IBS (irritable bowel syndrome)
Ischemic heart disease

Interstitial Cystitis

K

Kidney cancer
Kidney disease
Knee disorder & knee /replacement

L

Leukemia
Liver cancer
Liver disease
Lumbar degeneration
Lumbar disc disease

Lumbar discectomy

Lumbar laminaectomy
Lung cancer
Lung disease
Lupus (all kinds)
Lyme disease
Lymphadema

M

Macular edema/degeneration
Malignant hypertension
Manic disorder
Memory disorder
Meningitis
Migraine
Mood disorder
Morphine pump
Mouth cancer
Multiple allergies
Multiple chemical sensitivity
Multiple myeloma
Multiple personality disorder
Multiple Sclerosis
Myasthenia gravis

N

Narcolepsy
Neurogenic bladder
Neuropathy

O

Obsessive-compulsive disorder
Obstructive pulmonary disease
Organic mental disorder
Orthopnea
Orthostatic hypotension
Osteoarthritis
Osteomyelitis

P

Pancreatic cancer
Pancreatitis
Paralysis
Parkinsons Disease
Pericarditis
Peripheral neuropathy
Peripheral vascular disease
Peritonitis
Pernicious anemia
Personality disorder
Piriformis syndrome
Plantar fascitis
Polio/Post-polio syndrome
Polyglandular autoimmune syndrome
Polymyositis
Polyneuropathy
Pulmonary insufficiency
Post concussion syndrome
Post-traumatic stress disorder
Prostate cancer
Psoriasis

Psoriatic Arthritis
Psychosis

R

Raynaud’s disease
Reactive airway disease
Rectal cancer
Reflex loss
Reflex sympathetic dystrophy
Renal failure
Retardation
Retinitis Pigmentosa
Retinopathy
Rheumatoid arthritis
Rod dystrophy
Rod insertion (all kinds)
Ruptured aorta
Ruptured disc

S

Sarcoidosis
Schizophrenia
Sclerosing cholangitis
Scoliosis
Seizures (all kinds)
Sensory loss
Sjogren’s disease

Shingles (herpses zoster)
Sickle cell disease
Skin cancer

Sleep Apnea and other sleep disorders
Small fiber neuropathy
Somatization disorder
Spinal abcess
Spinal arachnoiditis
Spinal stenosis
Spondylolisthesis
Sleep apnea
Speech disorders
Spinal screws/rods
Spinal shunt
Spinal stimulator
Stomach cancer
Stroke
Subarachnoid hemmorrhage
Subdural hematoma

T
Temporal mandibular jaw dysfunction ("TMJ")
Tenosynovitis
Thoracic disc degeneration
Throat cancer
Thrombocytopenia
Thyroid disorders
Traumatic brain injury

Trigeminal neuralgia

U

Ulcers
Ulnar neuropathy

V

Vagus nerve dysfunction
Vascular insufficiency
Ventricular tachycardia
Vertigo
Vestibular dysfunction
Visceral pain
Visual efficiency loss
Vocal cord dysfunction
Vulvodynia

Zoster (herpes zoster)