Do You Know What Is Needed To File An ERISA Appeal?
Disability insurance claimants naively believe that managing their own disability claim is a simple process. There are disadvantages of managing your disability insurance matter, especially when filing your own appeal. The goal of an appeal is to overturn the insurance companies decision and to strengthen your case if you have to file a lawsuit.
With an ERISA governed policy an appeal is filed because your initial claim has been denied.
Group disability insurance policies have an internal appeals process when an unsympathetic decision has been made on your claim. At this point, the claimant must challenge the decision of the insurance company that just denied your claim.
Once you have been denied, it is up to you to use your appeal to strengthen your claim file and it is the claimants responsibility to show proof of loss and the only times you are able to do that is when your claim pending or at the appeal stage. If a vital piece of information is not included in your appeal, you will not be able to add that information to your lawsuit.
Remember, the insurer is seeking information to be utilized to deny or terminate benefits. Know the significance of what you tell and provide the insurance company. We are experienced ERISA attorneys and we understand what information needs to be included in your appeal. If you have been denied, please contact any of our lawyers for a free consultation.
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Mutual of Omaha
DENIED PRE-EXISTING
I filed a claim with Mutual of Omaha because I had a hip replacement surgery. My family doctor referred me to an orthopedic surgeon. Mutual of Omaha denied my claim saying...
Hartford
Total INCOMPETENCE!!!
They don't answer or return calls... lack of communication... unorganized... takes 3-4 weeks after approval to recieve a check... they mail checks on a friday... mailed me...
Lincoln Financial
Not getting paid on time
From the very start they have not tried to work with me at all. So I went out for a knee surgery and it took a month and a half to get my first check. When I had turned al...
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When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea...
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med...
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ...
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One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c...
Our Resolved Cases
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Lincoln Financial Disability Denial Reversed For Project Manager With Cardiac Condition
Lincoln Financial terminated long-term disability benefits for a North Carolina Hitachi Energy project manager after more than three years of payments — cutting him off precisely when the policy definition shifted from own occupation to any occupation. Our client had suffered a heart attack, required coronary stent placement and a pericardial window procedure,...
Commercial Real Estate Agent with Lyme Wins Northwestern Mutual Appeal
Northwestern Mutual denied a self-employed Texas commercial real estate agent's long-term disability claim by farming his file out to four separate paper reviewers — and then denied it a second time after his treating doctors disagreed. None of those reviewers ever examined him. None of them treated Lyme disease.Our client had spent years building a succes...
ERG International Customer Service Rep Wins Two MetLife Disability Appeals
MetLife denied our client's long-term disability claim twice in less than two years — both times by relying on a non-examining psychiatrist who never laid eyes on her, and both times by ignoring the lupus, connective-tissue disease, and joint hypermobility that were independently destroying her ability to work.Our client is a Texas customer service represe...
Hartford Denies Republic Services Truck Driver's Disability Benefits
Hartford terminated long-term disability benefits to a commercial driver who had survived two ventricular fibrillation cardiac arrests, lived with a permanently implanted defibrillator, and was federally barred from ever holding a CDL again. Hartford's stated reason was that the loss of his commercial driver's license, by itself, did not make him disabled.Ou...
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