What are The Risks of Doing An Appeal?


Frank Darras:

"One of the worst mistakes an individual policyholder can make is giving a carrier a second chance. Oh gee, Frank, the carrier said to me, I can appeal their wrongful denial. Well sure they said you can appeal their wrongful denial. It wasn't a mistake that they unreasonably denied your benefits. It wasn't happenstance that they took away your benefits."

"The carrier denied your claim, and they need to stand, and be accountable, and responsible for their actions that led up to that denial. Why in the world would you let them off the hook?"

"They had a duty to investigate. They had a duty to evaluate and they had a duty to put your claim in front of all the others and the interests of their own company. They should have looked at the claim with an eye towards payment."

"And some people are going to let them off the hook by doing an appeal. It gives the carrier a second chance to come in with a new team of doctors that are going to also say you weren't disabled. There's no reason to give an insurance company a second bite at the apple, unless your policy is ERISA preempted, and you need the help of a lawyer to make that determination."