by Steve Fields | July 18th, 2022
June 6, 2022 – U.S. Court of Appeals – 2nd Circuit – Unpublished Opinion
Reliance Standard determined that Caccavo had a change in employment status after being on claim and receiving benefits for a period of time. The employer informed Reliance Standard that Caccavo was back at work with limitations as of September 2016, consistent with Caccavo’s neuropsychologist opinion. Caccavo maintained that he had actually not returned to work, supplying to Reliance Standard countervailing evidence including statements from himself, his wife, his former supervisor, as well as an HR supervisor that advised the return to work information previously submitted to Reliance was in error.
Reliance asked for a copy of the team’s renewal contract and pay statements in light of the inconsistent information provided. Caccavo refused to provide such statements and revoked the employer’s ability to provide them. That refusal to provide the information was deemed to have infringed on Reliance Standard’s ability to thoroughly investigate the claim, and the refusal provided substantial evidence for Reliance Standard’s ultimate denial.
Claimants must carefully but also fully cooperate with the administration of their claim. Absent of some unusual or extraordinary circumstance, a refusal to cooperate or provide requested information to the insurance company is going to give them grounds to deny your claim and could very likely be upheld in Court. Having representation during the administration of your claim can help you avoid a lack of cooperation argument from the insurance company. An experienced ERISA disability attorney can help guide you on what to provide to the insurance company and when to provide it.
