Idaho Denied Disability Insurance Law

Residents of Idaho who have their Idaho insurance claim unfairly denied may be able to file a denied disability insurance lawsuit or a bad faith insurance lawsuit against their insurer. Depending on the circumstances of their insurance, they may either have to file an appeal or they may be able to file a lawsuit right away. Lawsuits and appeals have been filed in the US against companies such as CIGNA, AIG and Aetna. An Idaho disability insurance attorney can help, regardless of whether an appeal or a lawsuit is being filed.

If the long-term disability policy is offered by your employer—except for cases where your employer is a government entity or religious organization—then the Employee Retirement Income Security Act (ERISA) governs your insurance. If you have purchased the long-term disability policy on your own, separate from an employer, then ERISA does not apply.

If your insurance is governed by ERISA, then you are obligated to go through the insurance company's appeals process before filing a lawsuit. That process will involve important filing deadlines that must be met. If you do not exhaust the appeals process or if you miss the deadlines, you are not able to file a lawsuit to appeal the insurance company's denial.

If ERISA does not apply, you may be eligible to file a lawsuit as soon as your insurance claim is denied. It is important to check your contract, however, to make sure that you are not required to appeal through the insurance company first. Your contract, plus your state's statute of limitations, provide deadlines for filing appeals and lawsuits.

Insurance companies have a duty to act in good faith when reviewing the claims of their policyholders. If they have unfairly or unreasonably denied a claim, you have the right to file an appeal of that decision.

Denied disability lawsuits and appeals have been filed a variety of insurance companies—including AIG, Aetna and CIGNA, alleging those companies wrongfully denied legitimate insurance claims, possibly constituting bad faith insurance. Policyholders and regulators alike have been involved in complaints against insurance companies. In 2013, CIGNA agreed to a settlement with five state insurance regulators—including California and Connecticut—that saw the company pay fines to the states involved and change its claims handling procedure. That settlement came out of complaints that the company dismissed the findings of independent physicians and Social Security Disability when denying claims.

In Massachusetts in 2014, a judge ruled AIG operated in bad faith by denying a lawyer's claim following an accident in which he was hit by a bus. The judge found that AIG made up facts about the case and convinced the bus driver to change his story so the company could avoid a settlement with the plaintiff. The judge ordered the lawyer be paid more than $6 million, plus attorney's fees and costs.

In a different case, a woman fought against Aetna Life Insurance Co. in California, alleging the company's her disability claim was wrongfully denied. The court found that Aetna wrongfully denied Ruth Duarte's claim and ordered Aetna to give the Duarte the short-term disability benefits that had been taken away from her and review its denial of her long-term disability claim.

Although these cases were not filed in Idaho, many of the laws that apply in California and Massachusetts apply in Idaho.

Idaho Policyholders and beneficiaries can fight to get their disability denials reversed, through the courts or through the company's appeals process. Unfortunately, both processes can be long and complex, involving a great deal of paperwork and filing deadlines. Insurance companies may have the resources to drag out the process even longer or may continue denying the claim hoping the policyholder will give up. Insurance companies such as Unum, Aetna, AIG and CIGNA have all faced claims from policyholders or from state insurance commissioners alleging they improperly handled disability claims.

Idaho Denied Disability Legal Help

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Last updated on Jul-30-14