When it comes to disability insurance companies, there’s one universal truth: they don’t make money by approving claims. But there are options, and it’s important not to take a denied disability insurance claim as the final answer when it comes to your disability insurance determination. You may be able to appeal the denial of your insurance claim and, if the facts are in your favor, you can win. Read on to learn more about what’s involved in filing a disability insurance lawsuit against Guardian Disability.
Guardian Disability Benefit Denial Lawsuits and What a Claimant Should Expect
Guardian Disability denied disability claim letters generally cover two types of policies:
- Individual Disability Insurance (IDI) (including Berkshire policies (sold mostly to doctors, lawyers, and other professionals) and Guardian’s policies);
- policies governed by ERISA, or the Employee Retirement Income Security Act.
Both individual disability insurance and ERISA policies have their own advantages and disadvantages and can be very different when it comes to litigating a disability insurance denial-of-benefits claim.
A Guardian Individual Disability Policy Provides A Claimant With More Options than a Group Policy
Simply put, an individual disability insurance policy provides you with far more rights than an ERISA or group policy when you’re appealing a denial of coverage. If you enlist the attorneys at Dell & Schaefer to assist with your Guardian Disability claim, we’ll instantly be able to see whether you have an individual or ERISA policy as soon as we review the policy itself.
If you have an individual policy, you can choose to file in state or federal court – but if you have a group or ERISA policy, you’ll have to litigate your disability insurance claim in federal court, under broad federal laws and standards. Individual policies provide for a claimant’s potential recovery of not only the back benefits and attorney’s fees and costs, but also punitive damages (if you live in a state that allows punitive damages in breach-of-contract claims). ERISA policies, on the other hand, don’t allow disability insurance policy holders to request or recover punitive damages, no matter how egregious the insurer’s behavior was.
Finally, individual disability insurance policies allow claimants to request a jury trial, which can provide a huge advantage. Although the damages available are the same regardless of whether it’s a judge or jury trial, having the ability to present your case to a jury of your peers, cross-examine witnesses, and introduce documents can make the evidence of your disability seem more persuasive than a dry administrative record.
If you prevail in your claim, whether through litigation or in an out-of-court settlement, your case will be remanded for a determination of whether you’re currently disabled and are likely to remain disabled in the future.
Most Guardian Disability Insurance Lawsuits will Result in a Lump-Sum Buyout of Your Policy
What other types of case resolutions are common if your long term disability insurance appeal doesn’t ever make it to a jury (or judge)? The vast majority of these appeals settle before trial. This litigation is just too risky on both sides – insurance carriers don’t want to risk losing, and neither does the claimant (who may already be facing hefty medical bills or a long stint of unemployment).
Usually, before trial, a claimant’s attorney will send a settlement demand. When a disability insurance claim is settled, the claimant and insurance carrier have agreed to dismiss the claim for an agreed-upon lump sum to the plaintiff. The claimant will then sign a release making the policy null and void – essentially a “divorce” from the insurance company.
At Dell & Schaefer, let an experienced disability insurance attorney provide you with an immediate free consultation to discuss your Guardian Disability claim. Give us a call at 800-682-8331 or fill out the quick consultation form on our website to get in touch with one of our knowledgeable, compassionate attorneys today.