Private disability insurance companies do not make the process of filing a claim simple or easy. The standard of proof on your end is incredibly high. Most claims will be denied, or the insurance company will claim they require more information. For that reason, many people enlist the help of an ERISA disability appeal attorney to handle both the claims process and the appeals process.
A denial is not the end of the road. You can appeal the decision. CJ Henry Law Firm PLLC can guide you through the filing a claim with your ERISA disability insurance providers, as well as help you with your ERISA disability appeal in the event that your claim is denied. Contact us today to learn more.
The process will begin after you receive your denial. Many folks elect to have a lawyer intervene at this point. If an insurance company has any valid legal reason to deny a claim, they will. It is important to understand that this is just another step in the process.
They must, however, provide you with that reason citing any provision in the policy that would render your claim invalid. In the denial letter, they will also inform you of your right to an appeal and how to file the appeal. If the insurance company requires more information, they will generally tell you what information you require to satisfy the provisions of the policy.
Under ERISA law, the insurance company must give you 180 days from the date of denial to file an appeal. The insurance company has 45 days to respond to your appeal. They can also request two 30-day extensions if they have cause.
It is best to involve an attorney early in this process. Your attorney can use that 180 days to contact your doctors, other experts, and build your case. Depending on your policy, the next step is either to file a second appeal or go straight into litigation. This means preparing for a trial before a judge.
Your case will be tried before a judge, not a jury. The judge will look over your claim file. Your ERISA attorney will argue that the insurance company wrongfully denied your claim. It is important to understand that the information contained in your claim file is all the judge will be considering. In other words, you are not allowed to submit new evidence during the trial.
This is why it’s very important to engage an attorney early in the process. We can help you build your case during the appeals process (or even before) in order to ensure that everything you need to prove your case is already there. Hopefully, the case will not have to go before a judge but, in many cases, it will.
Once your case goes before a judge it is no longer a question of whether or not you have a disability. The question the judge will answer is whether or not the insurance company unlawfully denied your claim. This presupposes that you provided the insurance company with the requisite information during the claims or appeals process. In order to file a successful appeal, you must provide the following:
At CJ Henry Law Firm PLLC, we can help you increase your chances of success in winning an ERISA disability appeal. Contact us today learn more.