When a Florida resident gets seriously injured or sick and needs to file a claim on their disability insurance, they could be faced with an unexpected denial of benefits. Many group and other employer insurance plans are covered under ERISA, the federal Employment Retirement Income Security Act of 1974. In order to protect the right to sue the insurance company and receive deserved benefits, it can be particularly important to go through the appeals process with detailed preparation and key information.
Unfortunately, many claims for disability benefits are met with denials or lengthy delays on the part of the insurance company. Once an initial claim has been denied, the claimant has a specific period of time to respond and challenge that denial. By being prepared in advance, someone can be ready to respond in a timely fashion and protect their rights to further pursue their benefits claims.
The insurer may try to cancel the contract rather than simply denying the claim; in these cases, the insurance company will try to find some form of misstatement on the application in order to justify the denial. The applicant may then be left without benefits despite paying into a policy for years on end.
When filing an ERISA claim, it can only move forward to litigation after all of the administrative appeals have been exhausted. In some cases, the applicant can reach a settlement with their insurance company during this time.
When facing a denied ERISA disability insurance claim, one may feel like filing an appeal is hopeless, but it is important to establish a record of adherence to policy requirements. A disability insurance lawyer can help an applicant throughout the appeals process.