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Why You Need a Top Rated Attorney for Your Long-Term Group Disability Insurance Claims Dispute

When you suffer from a disability that requires you to take time off work or reduce your work hours, you worry. You may feel unsure of your health, and you may also worry about your ability to make a living and pay your regular bills. That’s why you have disability insurance coverage—or so you think.

Sixty-one million adults in the United States currently live with a disability. These people undoubtedly depend on individual or group disability insurance or federal disability benefits. However, despite paying premiums on time, your disability insurance carrier may wrongfully deny your valid disability claim outright. When you have a legitimate disability claim, this can prove extremely frustrating, many people simply walk away and don’t get the legal help they need. That’s exactly what the insurance company wants and hopes for.

A lawyer with experience in disability law can help you battle your disability carrier and collect the individual or group disability benefits you need and likely qualify to receive. It’s best to speak with a disability insurance legal representative before you file your claim, but if you’ve already received a claim denial, then time is of the essence.

Filing a Private Individual Claim or a Group Claim

Many people file a disability claim without the guidance of a disability lawyer. These individuals often receive immediate claim denials. Insurance carriers deny claims for many reasons, including for lack of sufficient medical, financial and occupational evidence.

When you file a claim, you must include all the documentation of your disability. That could include doctor’s notes, testing, medical records, physical therapy, pharmacy and prescription records, or even expert testimony. Otherwise, the disability insurance company may deny your claim.

Every disability carrier writes policies slightly differently, but they all have one thing in common: protecting the insurance company. One way that insurance companies protect themselves is by setting out broad terms for denying claims.

You may also feel confused about a letter you received. The Employee Retirement Income Security Act (ERISA) generally governs group disability policies that you received through work. This federal law may apply to your disability claim, and it’s difficult to navigate and understand. Partnering with a trusted legal advisor can help you understand your rights under ERISA.

Claim Denial

California LTD Insurance AttorneyInsurance companies deny disability claims at astounding rates. Most people who receive such denial from a group long-term disability insurance company will need to file a comprehensive and timely administrative appeal. Your odds of winning increase significantly if you retain a seasoned long-term disability lawyer.

The most common reasons that disability insurance companies deny claims include:

  • Lack of sufficient medical evidence supporting your disability;
  • Failure to follow treatment or doctor’s advice;
  • Failure to file your claim on time;
  • Failure to appear at a insurance company exam
  • Not providing updated medical, financial and occupational information.

These are broad reasons that give the disability insurance carrier ample room to deny your claim. You must do everything perfectly to succeed in your disability claim on the first try. Letting a skilled disability attorney guide you through this complex process can increase your chances of getting paid fully and on time.

Bad Faith

Sometimes, insurance companies deny claims without a valid reason. This unreasonable or denying without proper cause constitutes acting in bad faith. When you buy a disability insurance policy and experience a disability, you have a right to the timely receipt of disability benefits under your policy. Some insurance companies will deny your claim, even if you do everything right.

When this happens, you may have rich consumer rights and remedies. However, many people are not aware of their consumer rights, become frustrated by the process, and walk away without ever receiving their benefits. Do not let this happen to you.

In partnership with an experienced disability insurance attorney, you can expose the insurance company’s bad faith denial of your claim. To ensure fairness and that you recover maximum compensation, you should seek out assistance from an experienced long-term disability attorney.

Appealing With a Disability Insurance Lawyer

Even if your insurance provider did not act in bad faith, you still have options to fight against your wrongful claim denial. By filing an administrative appeal of your group disability claim’s wrongful denial, you can get another chance of collecting the disability benefits under your policy. Your administrative appeal depends on an experienced ERISA disability lawyer dotting every legal eye and crossing all the medical and occupational reasons as well.

Review Your Denial Letter

Your disability lawyer will first review your denial letter. In the letter, your provider must state the exact reason (or reasons) for denying your disability claim. For example, perhaps you did not provide enough medical evidence that proves your disability prevents you from working.

Many insurance companies will not list with specificity their reason for denial. This may indicate bad faith, or it could mean that the company hopes that you walk away and give up. Either way, your disability insurance lawyer can review your denial letter and advise you about your next steps.

Collect Additional Evidence

You may have submitted some evidence with your initial claim. By submitting additional evidence, however, your lawyer can increase the chances of success for your administrative appeal by providing all of the convincing medical evidence and proof needed to overcome your group insurer’s decision.

Your lawyer may include:

  • Additional medical evidence testing, treatment and documentation;
  • Letters from your treating doctor;
  • Testimony of your treating doctor;
  • Letters from witnesses you worked with;
  • Statements from family members; and
  • All additional evidence that supports your claim.

File Your Appeal on Time

Every disability provider lays out the timeline for your administrative appeal in your policy or certificate. You may not have reviewed your policy in a long time, so you may not realize that the deadline to file your administrative appeal is rapidly approaching. Many insurance carriers limit your time to file an administrative appeal to just 45 to 180 days after receiving your group ERISA claim denial.

Your disability insurance lawyer understands that you have limited time to file your comprehensive administrative appeal. Your attorney will work quickly to gather all the evidence that they need to give you the best chance of success. Missing this administrative appeal deadline may mean that you miss out completely on disability benefits to which you are entitled.

Using a Lawyer May Increase Your Chances of Success

Frank N. Darras
Frank N. Darras, Disability Attorney

Suffering a disability is bad enough. Having your insurance carrier, the company you thought would have your back in your time of need, leave you out in the cold, can prove traumatic.

If you have received a denial of your private individual claim or your group ERISA claim, do not give up hope, but do act fast. Time is of the essence, and you need to speak with an experienced and trusted disability lawyer today. Your ability to recover the compensation and benefits that you are entitled to under your disability plan will depend heavily on the lawyer you choose to help you file your claim and manage any administrative appeal or lawsuits.

Contact a long-term group disability lawyer today to speak with an experienced disability legal team that is not afraid to stand up to insurance companies and does administrative appeal denials with excellence. A top-rated long-term group disability lawyer can review your disability claim and your denial letter, and work toward a positive outcome in your administrative appeal and federal ERISA lawsuit.

DarrasLaw is Americas' most honored and decorated disability litigation firm in the country. Mr. Darras has seen more, evaluated more, litigated more, and resolved more individual and group long term disability and long-term care cases than any other lawyer in the United States.

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