At Disability Insurance Law Group, our national claims attorneys know Dearborn Group brand companies are licensed in all 50 states and the District of Columbia, the U.S. Virgin Islands, the British Virgin Islands, Guam, and Puerto Rico. Dearborn Group’s wide-ranging coverage results in reported net revenues of nearly $1.4 billion, total assets of almost $3.7 billion, and shareholders’ equity of over $670 million.
As the ancillary subsidiary of Health Care Service Corporation (HCSC), Dearborn Group provides employer-sponsored group plans and voluntary group plans to millions of employees.
Depending on the industry, many employers provide disability benefits as part of their employment packages. This is especially true for most group policies governed by the Employee Retirement Income Security Act of 1974 (ERISA), millions of which Dearborn Group underwrites.
While many workers believe that because their employers offer Dearborn Group policies, the insurer will provide little to no resistance when employees need to pursue their disability benefits. Unfortunately, it takes very little time to learn this is untrue.
That is why we are here. Our disability insurance attorneys represent Dearborn Group policyholders nationwide — no matter where they live or work in the U.S. — with their best interests and true success in mind so our clients can pursue the benefits they are entitled to from their employer-provided coverage or policies. Contact us today to learn more.
The challenges associated with pursuing disability claims through the Employee Retirement Income Security Act (ERISA) governed policies stem from the unique characteristics of ERISA and the way it regulates employer-sponsored benefit plans, including disability insurance.
Here are some reasons why ERISA-governed disability claims can be challenging:
ERISA sets specific standards for employee benefit plans, including disability insurance. Many ERISA-governed policies are standardized, making it challenging for policyholders to negotiate or customize terms. This lack of flexibility can lead to limited options for policyholders.
ERISA imposes strict deadlines for filing claims and appeals. Policyholders must adhere to these timelines, and missing deadlines can result in the loss of benefits. The strict deadlines can be challenging, particularly for individuals with health issues.
ERISA requires detailed administrative procedures for handling benefit claims and appeals. Policyholders must follow these procedures precisely, and failure to do so could result in the loss of certain rights. The administrative process can be complex, and policyholders may struggle to navigate without legal assistance.
ERISA imposes a relatively short statute of limitations for filing a lawsuit after exhausting the internal appeals process. This limited timeframe can create challenges for policyholders, particularly if they face delays during the internal review.
ERISA preempts many state laws related to insurance regulation. This means that ERISA-governed disability claims are subject to federal law, and policyholders may not benefit from specific state consumer protection laws that could be applicable in non-ERISA cases.
In many ERISA-governed plans, the same entity responsible for administering the plan is also responsible for making benefit determinations. This inherent conflict of interest can create skepticism about the fairness of the claims process, as the entity making the decisions also has a financial interest in denying claims.
If you have a Dearborn Group disability insurance policy governed by ERISA, it generally limits the ability of policyholders to pursue legal action through the court system.
Instead, claims disputes often go through an internal appeals process outlined by the insurance company or plan administrator. If the internal appeals process is exhausted, the policyholder’s recourse may be limited to filing a lawsuit, but the judicial review is typically deferential to the plan administrator’s decision.
If a policyholder decides to pursue a lawsuit after exhausting the internal appeals process, the scope of discovery in ERISA cases is often limited. This means that policyholders may have restricted access to certain information that could be crucial to their case.
Given these challenges, policyholders pursuing disability claims under ERISA-governed policies benefit from seeking legal advice early in the process to understand their rights, navigate administrative procedures, and, if necessary, explore their options for legal recourse.
That is why we are here.
With over 50 combined years of experience, our nationwide Dearborn Group disability insurance attorneys specialize in ERISA claims. Whether you are considering applying for benefits, are waiting for a claim’s decision, or have been denied, we can assist you with your Dearborn Group disability claim anywhere in the country, starting with a free consultation.
We are fully dedicated to providing transparent legal services that allow us to pursue real results for real people who need our help – no matter where they live or work in the U.S.
If you are receiving resistance from Dearborn Group for your U.S. disability claim, or if your claim has already been denied, contact our dedicated disability insurance attorneys nationwide at 954-989-9000 or online to schedule a free, confidential case assessment without delay.
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