Insurance Companies such as Aetna, Assurant, Berkshire, Cigna, Guardian, Liberty Mutual, MetLife, Reliance, Standard, and Unum are well-known for unfair and biased claims review processes, misrepresenting the facts, and for denying valid disability benefit claims. Under the terms of most disability policies and the law, insurance companies are obligated to fully and fairly review each case, engage in proper investigative methods, and timely pay claims to those insureds who are unable to perform the material duties of their occupation and/or any occupation.
Unfortunately, these companies too often fail to conduct a full and fair review; instead approaching each claim with the intent of finding any reason upon which to base a denial. Insureds are often shocked that, despite ample proof of disability, their claim has been denied. Many feel powerless and simply give up. Others appeal the denial of benefits without fully understanding their rights under the policy and/or applicable state and federal law and the importance of submitting a detailed appeal that, if necessary, can stand up in court.
Your Insurance Claim may fall under ERISA Law
ERISA is a federal statute that applies to many employer provided disability plans and which imposes strict deadlines and guidelines by which claimants and insurance companies must abide during the initial claim evaluation process, the appeal process, and if a lawsuit is filed. Unfortunately, ERISA creates an unequal claims process, placing rigorous obligations on individuals pursuing benefits and making it relatively easy for disability insurance companies to reject disability claims without fear of penalty.
When a claim for disability benefits governed by ERISA is denied, the claimant MUST submit an administrative appeal. If you do not, you may be barred from further pursuing your claim.
If you are appealing a denial of benefits or even applying for benefits under an ERISA governed plan, you should be aware of your obligations in proving your claim and the strict deadlines and limitations imposed by ERISA. If you are unsure whether or not your disability benefit plan or policy is ERISA-governed, you should seek clarification. The assistance of an attorney well versed in ERISA law and familiar with the delay and denial tactics of disability insurance companies can help you obtain the disability benefits to which you are entitled.
What to Do If Your Claim has been Denied
The Denial letter should clearly state the reasons for denial, the sections of the disability policy or plan upon which the denial was based, and a detailed explanation as to why the company believes you are able to return to work either in your own occupation or any occupation. At this point it is smart to consult an attorney to better explain your rights under your policy, your obligations under the policy, and what steps, if any must be taken so that you do not lose your right to appeal the claim and/or file a lawsuit if a final denial is issued. If you do not meet your obligations you may be forever barred from further seeking benefits under the policy. A well-prepared appeal often results in the overturning of a denial without the need for a lawsuit.
Disability Insurance Law Group Can Help Get You the Disability Benefits you Deserve
If your disability insurance claim has been denied it is vital that you take the steps necessary to fully understand your rights and obligations under your disability policy or plan and seek the assistance of an attorney that understands the disability benefits process, has experience dealing with the unfair claim delay and denial tactics of most insurance carriers, has successfully convinced these carriers to overturn their wrongful denials, is experienced in litigating these unique claims, and has successfully gone up against numerous insurance carriers many times. The attorneys at Disability Insurance Law Group are committed to aggressively asserting our clients’ rights in and out of the courtroom. We are known by the insurance companies, benefits administrators, and their attorneys for our experience, skill, and understanding of the law. The insurance companies have a team of lawyers, shouldn’t you? Let Us Help You Fight a Denied or Delayed Claim. Contact us at www.dilawgroup.com or at (866) 363-3628.