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WJAR NBC 10: Kilpatrick Helps Pass Law To Ban Discretionary Clauses

Gov. Lincoln Chafee signed into law Tuesday a measure that bans insurance companies from denying long-term disability benefits.

NBC 10 Chief I-Team reporter Jim Taricani first brought the issue to light in a March 2013 report that detailed the case of Dr. Douglas Blake.

Blake’s inability to work due to excruciating back pain was well documented, but his health insurer denied his disability claim.

He appealed in federal court, but lost.

Until recently, Rhode Island law allowed for so-called discretionary clauses in health insurance contracts, forcing judges to decide coverage appeals not on their merits, but only on whether the insurance company denied the claim arbitrarily.

Douglas won his disability benefits after a two-year fight and thousands of dollars in legal fees.

His attorney, Scott Kilpatrick, mounted an educational and outreach campaign for state lawmakers, who passed a bill prohibiting the discretionary clause.

Rhode Island becomes the 21st state to ban discretionary clauses.

-Jim Taricani

Category: ERISA Law

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