Receiving notice that Mutual of Omaha has denied your claim for long term disability benefits can be disheartening. You may be worried about making ends meet and wondering what to do next. Fortunately, you don’t have to go through this alone. The disability insurance attorneys at Dell & Schaefer have handled thousands of these claims and can fight for your rights under your long term disability policy. Learn more about what claimants can expect after Mutual of Omaha denies a claim for long term disability insurance benefits.
The Mutual of Omaha Denial Letter and Claim File are the Starting Point for Evaluating the Merits of a Lawsuit
The first steps your attorney will take after a disability claim is denied is to obtain and review the denial letter and order a copy of the disability claim file. Not only will this claim file include all the medical documents Mutual of Omaha has gathered (which your attorney will need to evaluate the merits of your claim), but it will also have Mutual of Omaha’s own internal reviews, which can help point claimants toward any weaknesses in their initial application for disability insurance benefits. By knowing what documents are missing from the claim file or insufficient for Mutual of Omaha’s purposes, claimants can have a far better idea of what they’ll need to show and prove to obtain approval of disability insurance benefits.
ERISA Disability Lawsuits Are Unique as All Information is Required to be in the Claim File
Many Mutual of Omaha long term disability policies are issued under the Employee Retirement Income Security Act (ERISA), a federal law that offers a number of protections for insurance companies and relatively few to claimants. When a claimant sues their insurance carrier under an ERISA policy, the claim proceeds in federal court, and the judge can only consider the information already in the claim file. This means that even if a claimant is obviously and visibly disabled, their claim is only as strong as it appears on paper, and any holes in this claim can support a denial of benefits.
Mutual of Omaha Takes a Strong Position in Supporting Their Disability Denials
Mutual of Omaha does its homework when it comes to denying long term disability benefits. The level of detail in Mutual of Omaha’s disability denial letters can be a double-edged sword when it comes to overcoming a denial based on the “arbitrary or capricious” standard ERISA claims rely on. On one hand, having a better idea of what Mutual of Omaha relied on when denying a claim can make a denial easier to rebut; but on the other, showing that a denial was arbitrary can be harder when it’s clear the claim representative put some work into the investigation.
Winning a Lawsuit Gets You Back Benefits and the Right to Have Your Claim Re-evaluated for Future Benefits
When your Mutual of Omaha long term disability claim is approved, you’ll receive benefits dating back from the time frame you should have been approved for disability benefits. But judges don’t award open-ended benefits into the future, and Mutual of Omaha may re-evaluate your claim and deny it again later if it determines you’re no longer disabled according to the terms of the policy.
A “remand” is a Scary Outcome of More than 50% of ERISA Disability Lawsuits
One possible outcome of ERISA claims is a remand, in which the judge orders Mutual of Omaha to re-review the claim file for another bite at the apple. Having a judge tell Mutual of Omaha that its initial claim review was arbitrary or capricious may seem like a victory, but can still ultimately lead to a denial if Mutual of Omaha comes up with additional grounds for denial on its second review.
Claimants can always benefit from having an attorney to guide them through this process, ensuring that the claim file is as complete as it can be before review. Get in touch with Dell & Schaefer today to set up your FREE consultation with one of our experienced disability insurance attorneys.