Insurance companies that offer long-term disability policies protect the interests of their policyholders and themselves, not their beneficiaries. If there exists any legal way for an insurance company to deny a claim, they likely will. They will not go out of their way to prove the validity of your claim. They will only go out of their way to disprove the validity of your claim. If you’ve made a claim on your long-term disability policy, you may be in for a significant battle.
At CJ Henry Law Firm, we have successfully helped our clients appeal denied disability insurance claims. If you have had your first claim denied, the battle isn’t over; it’s just begun. Contact us today to speak to a denied insurance claim lawyer.
Our first order of business will be to get a copy of the insurance policy. Different insurance policies have different terms. They can even define “long-term disability” in such a way that allows them to deny all but the most serious of claims. For instance, what if your policy defines disability as not being able to do your present job? Then all you would need to prove is that you’re incapable of doing the job for which you are employed. If, however, the policy defines disability as an incapacity to do any job at all, then you might as well be comatose before you see a dime.
If you’re the one who’s doing the purchasing, it behooves you to look into the terms of your policy before purchasing it. But if you either didn’t or it was purchased as a group plan by your employer, then the next step in the process is to request a copy of the policy. If you hire an attorney, that’s precisely what we would do.
One thing to consider, however, is that getting a copy of the policy may not be as simple as it sounds. You will want to make a formal request in writing and send it via certified mail. ERISA requires that the insurance company that is furnishing your long-term disability policy disclose a copy of the policy upon request. Failure to do so is a violation of federal law.
Next, you will want to go over the denial letter with a fine-tooth comb. When an insurance company denies your claim, they need to provide you with a valid reason. No matter how specious that reason is, it forestalls the process of actually paying out your claim. It also forces you into the position of providing additional proof. In this manner, they weed out those who aren’t prepared or willing to engage in a protracted battle.
For those with policies that pay out in the event that they can no longer perform their current job, it may be a matter of going to a doctor that they select or providing them with ample medical records. If you hire a lawyer, we can also have a vocational expert testify on your behalf. We can also get various doctors and medical evidence to testify to ensure that your claim is legally undeniable.
Chances are if you require long-term disability, you don’t want to be running yourself ragged trying to track down expert opinions and medical evidence to stack your claim. At that point, the insurance company can turn around and argue that if you’re capable of doing all that then you should be able to do your job.
Generally, long-term disability policies pay out for a period of a couple of years given the condition that you cannot do your current job. This gives you time to learn another skill and then seek new employment in a different field. In some cases, these policies will later only pay out on the condition that you can no longer do any job. In some cases, this is fair and in others, it isn’t. But at least you have time to recover and then think about securing other employment down the line.
In all likelihood, any claim you make yourself is likely to be denied if for no other reason than the insurance company wants to know that your heart is really in it. If even 10% of claimants back off after an initial denial then the insurance company has saved itself millions of dollars each year. Contact a denied insurance claim lawyer at CJ Henry Law Firm. We may be able to help you recover the money you need.