Disability insurance attorney, Gregory Dell, of Dell and Schaefer, summarizes the new regulation text in the following way: “If the plan will rely upon new evidence or rationale to support its denial and appeal, the plan must provide such information to the claimant as soon as possible and sufficiently in advance of the date on which the notice of the adverse benefit determination on review is due.”

In lay person terms, this means that insurance companies cannot spring new information on a claimant regarding their plan without sufficient notice. Nor can insurance companies suddenly introduce a new doctor or new information in a disability insurance case in which a claimant’s insurance is on the line. In other words: communication, communication, communication. No surprises, no plot twists, no last minute information or doctor testimonies unless they’ve made their intent known in advance.

What kind of impact will this regulation have on a long-term disability plan? Gregory Dell asks attorney Stephen Jessup his opinion on these regulations. Stephen Jessup goes into the importance of checking the credibility of doctors that insurance companies use. It’s worth investigating the credentials of these doctors; there have been cases of identity theft and posers who are not even doctors assuming the name of a real doctor and being a mere pawn of insurance companies. Moreover, these doctors are chosen to reiterate and affirm the bias of the insurance company first and foremost, not provide an objective, neutral evaluation. So, what these regulations support is the claimant and lawyer’s time to look into the doctors used and not be blindsided by a sudden surprise doctor’s piece of evidence last minute introduced to the case that may not even be legitimate.

In the past, claimants were denied opportunity to comment on new arguments insurance companies brought forth during the appeal process. With these new ERISA regulations in play, claimants are more informed throughout.