Andrew’s Answers: Discretionary Clauses & States That Ban Them

Disability attorney Andrew November wants you to know about discretionary clauses and how they can impact your disability case. In most disability cases, a claim is resolved against the company that drafted the contract, in this case, the insurance company. But with a discretionary clause, that goes out the window.

To tackle this topic, we have to answer the question: what is a discretionary clause? A discretionary clause is a clause in your LTD policy that gives the insurance company complete control to make a determination on your disability claim or appeal, based on evidence that the insurance company thinks is sufficient. 

Discretionary clauses make disability cases so difficult, and it is important to know if your policy has one before you become disabled. Because these clauses are so confusing and complicated, many states have banned them. Unfortunately, Ohio has not. 

Whether discretionary clauses are banned does not necessarily depend on the state you live in, but rather the state your insurance policy was issued. Here are the states that ban discretionary clauses in 2021:

  1. California
  2. Connecticut
  3. Hawaii
  4. Idaho
  5. Illinois
  6. Indiana
  7. Kentucky
  8. Maine
  9. Maryland
  10. Michigan
  11. Minnesota
  12. New Jersey
  13. New York
  14. Oregon
  15. South Dakota
  16. Texas
  17. Utah
  18. Vermont
  19. Washington
  20. Wyoming

If you have questions about discretionary clauses or anything else, submit them by clicking here.