Skilled Insurance Bad Faith Lawyers in Ohio
According to statistics from the Centers of Disease Control and Prevention (CDC), there are over 2.3 million Ohio residents living with some form of disability. This amounts to roughly 25% of the state’s population.
Many people who develop a disabling illness or injury in Ohio should be able to rely on monthly benefits from a long-term disability insurance policy. Unfortunately, collecting these monthly disability insurance benefits isn’t always as easy as submitting a claim and receiving a check. Insurance companies frequently try to wrongfully delay or deny valid claims using various strategies.
If you find yourself in this position, you need to enlist the help of an Ohio insurance bad faith disability lawyer.
Should You Hire an Ohio Insurance Bad Faith Lawyer?
The first factor to consider when it comes to a potential disability insurance lawsuit is whether or not your policy is employer-sponsored or individually purchased. If it’s the latter, a bad faith insurance lawsuit is most likely the type of legal challenge you’ll need to launch.
If your policy is employer-sponsored, you cannot bring your insurance company straight to court with a bad faith insurance lawsuit. These policies are governed by a body of federal legislation called the Employee Retirement Income Security Act of 1974 (ERISA). The legislation sets out a mandatory appeals process you must complete before taking your case to court.
You should note that there are some limited exceptions to the general rule that employer-sponsored disability insurance policies fall under the authority of ERISA. If you’re not sure whether your policy is subject to the legislation, a seasoned long-term disability attorney will be able to provide guidance. Our top-class long-term disability insurance attorneys work on cases involving both individually purchased and employer-sponsored policies, so we’ll be able to help you one way or the other.
How Does an Ohio Insurance Bad Faith Lawsuit Work?
As a plaintiff in a bad faith insurance lawsuit, you need to prove to the court that your insurance provider breached its contract with you by failing to act in good faith with your claim. You may be able to establish this in a number of ways, including:
- Showing that the company failed to conduct a proper and adequate investigation of your claim. Insurers have a duty to act with a reasonable degree of care in investigating claims and must consider all relevant information.
- Highlighting misrepresentation in policy provisions: Insurers cannot deliberately or recklessly provide false or misleading information about the terms of your coverage.
- Proving that your insurer acted in a vexatious manner. Insurance companies cannot act with an intentional disregard for the individual disability policyholder’s rights.
It’s important to note that, under Ohio’s common law, you do not have to prove that an insurer acted intentionally to prove there was bad faith. In the 1994 case of Zoppo v. Homestead Insurance Company, the Ohio Supreme Court confirmed that an insurer defendant may be liable for damages in a bad faith lawsuit where there was no “reasonable justification” for its failure to pay out on a claim.
Why Your Disability Insurance Claim Was Denied
There are many common reasons for denials or delays on long-term disability insurance claims in Ohio. It’s important to remember that adverse benefit decisions are not final; with the help of a top-class long-term disability lawyer specializing in the field, you may be able to establish that your insurance company delayed or wrongfully denied your claim in error.
Some common reasons for adverse benefit determinations include:
- Exclusions: Your insurer may try to escape liability on the grounds that an exclusion on your policy invalidates your claim. Insurance policy contracts are deliberately complex, so it can be difficult to dispute an assertion like this without expert legal help.
- Failure to provide adequate proof of loss: You must provide timely, comprehensive evidence of your disability and vocational circumstances when filing a claim. Should you overlook some item of required documentation, your insurer may be entitled to delay or deny your claim.
- Time limits: Insurance policies typically specify a time frame within which claims or proof of loss must be filed. If you fail to file a claim within this time frame, the disability insurance claim may be denied.
When Do You Become Entitled to Long-Term Disability Insurance Benefits?
In order for monthly benefits to become payable on your long-term disability insurance policy, you must satisfy a number of requirements. These are:
- You must visit your physician and have them confirm that your illness or injury rises to the level of a disability, as the term is defined in your policy.
- Your physician must administer the most medically appropriate and suitable course of treatment for your condition.
- The elimination period (also known as a waiting period) on your policy must have elapsed. These periods vary significantly from one policy to the next, so you should always consult your own policy to see what period will apply in your case (ideally with the help of your long-term disability attorney).
Contact an Ohio Insurance Bad Faith Lawyer and Get the Benefits You Deserve
Receiving the news that you’ll be unable to work because of a disabling sickness or injury is a frightening experience; if your insurance company informs you it won’t pay out on your claim, that will only compound your difficulties. However, an Ohio insurance bad faith lawyer will be able to help you challenge your adverse benefit determination, giving you the best possible chance of emerging with a favorable result.
Contact DarrasLaw today to schedule a free initial disability insurance consultation, including a free claim or policy analysis or free initial assistance with an appeal.