Denied Disability Insurance
Both short-term disability and long-term disability policies are purchased as insurance to protect you in the event that you become disabled and can no longer work. But countless policy holders are denied disability insurance by insurers who employ bad faith practices. Experienced long-term disability insurance lawyers can help consumers appeal wrongly denied disability claims and file a long term disability lawsuit.
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Denied Disability Insurance
Short-Term Disability Denial—Am I Eligible for Benefits?
These benefits can be funded and administered by an insurer or funded by the employer and administered by a third party administrator. The employer is usually involved with a short-term disability claim.
If you are denied short-term disability, you have the right to appeal. Disability insurance attorneys advise you to examine your policy and make sure your disability falls within its definition of STD. Next, have your physician re-evaluate your condition and obtain a copy of your medical record—it will be required as evidence with your appeal. Lastly, consult with a bad faith insurance attorney who is experienced in short-term disability claims.
Long-Term Disability Denial—Am I Eligible for Benefits?
Most people believe their long-term disability (LTD) benefits cover injuries that are work-related only. However, it is estimated that more than 95 percent of LTD claims are non-work related, such as chronic diseases, mental illness and cancer. These illnesses and more may be covered on your LTD benefits policy.
If you have made a claim under a long-term disability policy and have had your claim denied, or if your claim was approved and then later terminated, you have the right to appeal and an attorney can help determine if you are eligible for substantial additional benefits.
Long-term disability policyholders in Washington, Oregon, Hawaii, Alaska, Montana, Idaho, California, Nevada and Arizona who have had their LTD claims unfairly or unreasonably delayed or denied may be eligible to file a lawsuit against their long-term insurance company.
Long-term insurance companies that have or could face a denied disability claim include Cigna, The Hartford, Aetna, Lincoln Financial, Sunlife, Prudential, Liberty Life, Reliance Standard, Sedgwick, Dearborn National, MetLife, Principal Financial Group, Guardian Life, The Standard, Mass Mutual, Union Central, Lloyd's of London, Illinois Mutual, Assurity and Fidelity Insurance Group.
Denied Disability Lawsuit
Wrongfully Denied Disability and ERISA
ERISA is a government statute comprising a series of regulations. These regulations, however, are rarely enforced by the Department of Labor, thereby allowing the insurance industry to employ bad faith practices and denying your claim. Because ERISA is so complicated and evolving, you need an experienced attorney to understand and identify bad faith tactics by the insurer.
The ERISA law regulates most every aspect of employee welfare benefits. Even though it is a complex set of rules, ERISA was set up in 1974 to give you the right to pursue a lawsuit in federal court. Be aware that a disability lawsuit occurs before a judge only (no jury) who will review only those administrative documents on record—you seldom have a second chance so it is imperative that you seek an experienced ERISA attorney.
To file an ERISA claim you must do the following:
File an initial claim with your insurer and typically within 45 days a claims reviewer will determine whether you are entitled to disability benefits
If you are denied benefits, you can either accept that decision or appeal for another review by the insurance company. The insurance company must explain to you the reason for their denial.
Be aware that both processes involve deadlines, which should be clearly defined in your letter of denial. As a rule, you will have only 180 days to file an administrative appeal of the denial.
If you fail to meet these deadlines, you may lose all rights of appeal and your right to file a wrongfully denied disability lawsuit.
If you have appealed your case under ERISA and haven't received a decision within 45 days, disability insurance lawyers advise that you file a lawsuit sooner than later. It is advantageous for you that a judge receives documentation from your attorney rather than just reviewing documentation from the insurance company that denied your claim.
For more ERISA information visit The Department of Labor(DOL) website and ERISA commonly asked questions.
Common Claim Denials
Bad Faith Disability Insurance
Besides intentionally denying a claim, Insurers are well-versed in a number of insurance denial tactics, such as:
- Misclassifying injuries and/or insisting your medical condition is pre-existing
- Denying your medical records and/or claiming you lack "objective medical evidence"
- Relying on evidence by their independent medical examiner
- Partial payments on disability claims
- Unreasonable denial, delay, or policy termination
- Concealing benefits from policyholders
- Insisting you are able to work in another occupation
Register your Denied Disability Claim ComplaintIf you or a loved one has been Denied a Short-Term or Long-Term Disability claim, you may qualify for damages or remedies that may be awarded in a possible lawsuit. Please fill in our form to submit your complaint and we will have a lawyer review your Insurance complaint.
At LawyersandSettlements.com, it is our goal to keep you informed about important legal cases and settlements. We are dedicated to helping you resolve your legal complaints.
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