Most organisations encourage or enroll their employees into disability insurance policy and programs. These entitle the participants to certain compensations in case they suffer because of some injury or cannot work because of the illness. These policies can be self-funded by the organisation, availed via third-party insurance companies or under some government program.
In case you suffer from an illness or an injury that hinders you to do your job, you can appeal for a short-term or long-term disability claim. However, in some cases, insurance carriers deny these claims for various reasons. If your employment is covered under disability insurance, here’s what you need to know about it and the claims.
Types of disability benefits
Broadly, there are two types of disability benefits – short term and long term. The long term benefits can be claimed in succession to the short term benefits if the short term is exhausted and the disability persists. Based on the kind of employment, nature of work, age, and medical history, disability, etc. these benefits may vary.
Were you denied disability benefits?
If you have been denied your disability benefits claim by your insurance carrier, you can take legal actions against the company. With the help of an experienced ERISA lawyer, you can file a lawsuit and claim your benefits.
ERISA cases are quite tricky as they are handled in federal courts and are fairly different from any other lawsuit. The case is driven by a federal judge and at their discretion. In an ERISA lawsuit, there are no trials, rather, the attorneys represent their clients in front of the federal judge who assesses the motion, the claim, and denial via Standard of Review.
This review process evaluates the policy and the claim, policy holder’s medical records and grounds of denial. Based on this review, the judge can give a verdict for or against the motion.
However, it is an extremely delicate matter and it takes a compelling appeal and litigation to get a judge to be in your favour.
Insurer’s “Jail free card“
Insurance carriers often add a discretion clause to the policy, stating that the carrier can withdraw the benefits or deny the claim for various reasons. With this, policy providers get an undue advantage to dictate the terms and deny the claim at will. If a policy has a discretion clause, there is very little scope for the judge to reverse a denial – hence a “get out of jail free card” for the insurer.
How can your attorney be a game changer?
In case of disability benefit lawsuits, there are a lot of variables in play and it is risky for both the parties. Hence, in many cases, insurance companies bring up settlement offers and you would need an experienced ERISA lawyer to put out aggressive negotiations and get the right deal.
Through a lawsuit, you can claim numerous disability benefits along with litigation fees and compensations.
The Law Office of Nancy L. Cavey is a renowned disability law firm that can help you claim the disability benefits you deserve.