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Insurance company faces alleged violation of ERISA

On Behalf of | Dec 7, 2018 | Denied Long Term Care Claims |

A long-term disability policy is designed to help a Florida resident pay for costs related to treating medical issues. According to one woman, Liberty Life Assurance Co. failed to live up to the terms of a policy that she participated in. The suit was filed in U.S. District Court for the Southern District of Illinois, and it claimed that Liberty’s actions were in violation of the Employee Retirement Income Security Act (ERISA).

According to the woman’s complaint, she stopped receiving benefits in April 2016. Furthermore, the complaint states that her claim was not given a fair review by Liberty Life Assurance. As a result, she is asking that Liberty pay the benefits that she is owed under the policy plus interest. The lawsuit also requests that court costs and legal fees be paid for by the defendant in this matter.

If an individual pays their insurance premiums, they’re usually entitled to receive coverage per the terms of the policy. While an insurance company is not necessarily required to pay out a claim, it must generally make a good faith effort to review claims that do come in. Furthermore, a policyholder often has the right to appeal denied long-term care insurance claims or take other action in an effort to get a denial reversed.

In the event that an insurance company refuses to act in good faith, a policyholder may benefit from hiring an attorney. A legal professional may review an insurance policy to determine if an individual has a case against the coverage provider. Legal counsel could send letters to an insurance company or take other steps to facilitate a favorable outcome for an individual. These steps may include engaging in settlement talks or arbitration hearings.