Our firm handles disputes against wrongful denials of long-term disability insurance benefits from Colonial Life & Accident Insurance Company. If you have had your claim denied by Colonial Life, or if your benefits were granted and then later terminated, we may be able to help you receive the benefits you deserve.
Colonial Life offers a variety of insurance products including long-term disability, accident, life, cancer, and critical illness coverage. They also provide voluntary disability benefits (purchased by individual employees) to round out an employer’s core benefits program.
Colonial Life is a stand-alone business of Unum Group, which is a market leader in disability, life and many other insurance plans. Founded in 1939, today Colonial Life has around 3 million insurance policies in effect, serving over 70,000 businesses.
If you are dealing with a denied disability claim, consider that your well-being is not necessarily in the interest of the insurance company. Having skilled long-term disability attorneys working on your behalf – as early in the process as possible – is in your best interest.
Marc Whitehead & Associates assists people across the United States in their efforts to appeal Colonial disability claims denial under ERISA law and/or termination of disability coverage.
What to Do If Colonial Life Delays Your Claim
As a general rule, an insurance carrier should make a decision regarding a claim in about 90 business days. If Colonial Life delays your claim, it is important to contact them to find out why. It is likely that there is some additional material they need, and it is critical to learn what that is so you can provide the company with the information as soon as possible.
Keep good records
Colonial Life must receive all pertinent medical records before it makes a decision. Unfortunately, if you fail to provide documents in a timely manner, the responsibility falls on you, not the insurance company. Make sure you keep good records regarding all information sent to the insurer and make a copy of all submissions.
Delaying tactics
On the other hand, you may feel Colonial Life is giving you the runaround. Perhaps they are not even bothering to respond to your inquiries, whether made by email or phone.
Unfortunately, delaying tactics is common for insurance companies providing long-term disability policies. Even if you have always paid your premiums on time, the insurer wants to do everything it can to delay and then deny your claim. That is the business model. The insurer makes money investing your premium payments, not paying out claims.
Common reasons for claim delays
Common reasons for Colonial Life claim delays include:
- Determining whether your claim is due to pre-existing conditions.
- More information is needed about daily activities and how your condition affects them.
- Forms are not submitted.
- Forms are filled out incorrectly.
Examination by an Independent medical examiner
In some cases, Colonial Life may want to have you examined by an independent medical examiner of their choice, meaning the examiner is likely to side with the insurer if possible. After the examination, the insurance company may have the medical examiner or its peer review physician contact your doctor to discuss the examination’s conclusions. This further delays the process.
While you must abide by the guidelines in your policy, all too often, this is just a stalling maneuver on the part of the insurer. When the insurance company demands an independent evaluation, it is trying to find ways to deny your claim.
Do not be surprised if the insurer’s medical examiner finds that your physician is mistaken regarding your limitations and restrictions and determines you to be capable of working.
Don’t lose any more time. Get a disability insurance attorney involved.
If you do not receive a satisfactory answer for the reason for your claim delay from Colonial Life, get in touch with a disability insurance attorney right away. We know the tactics used by insurance companies to delay and subsequently deny claims.
By getting a lawyer involved promptly, you increase the odds of having your claim decided within a reasonable timeframe. Your attorney will get straight answers from Colonial Life.
What Happens After I Meet with an Attorney?
If you decide to hire an attorney to help you pursue justice against Colonial Life, they will advise you on the next steps. This may include submitting additional medical tests or exams to enhance the strength of your claim, which may increase your chances of an appeal. Remember, though, that if you need to file a lawsuit against Colonial Life, you will only be able to use the information in your file as part of your claim. So even if Colonial Life denies your appeal internally, your lawyer can still help build your case by amplifying the documentation contained in your file.
The group disability plans that Colonial Life offers through employers are governed by the Employee Retirement Income Security Act (ERISA). So, you are required to file an appeal of your denial before becoming eligible to file a lawsuit. Your notice of denial will specify why the company denied your claim and how you can appeal that decision. This letter will also provide a deadline. If you miss that deadline, you may forego all legal rights to your disability claim. However, skilled legal representation will ensure that this doesn’t happen.
Common Strategies Used by Colonial Life
Keep in mind that insurance companies are businesses focused on maximizing the bottom line. Because of that, Colonial Life may do whatever it can to limit or deny your financial compensation.
Some of Colonial Life’s commonly employed strategies to accomplish this goal include the following:
- The company may misrepresent your job duties as justification for rejecting your claim.
- Colonial Life may refuse to believe the accuracy of your subjective claims about fatigue, pain, and suffering.
- Colonial Life may falsely claim insufficient medical evidence to support your claim.
In employing these tactics, the company aims to wear you down to the extent that you give up fighting for your disability claim, even though it may be perfectly valid. Unfortunately for Colonial Life, experienced disability attorneys are familiar with these strategies and know how to contend with them to achieve justice on behalf of their clients.
Colonial Disability Claims and Denial Disputes are Controlled by ERISA Law
In 1974, Congress passed the Employee Retirement Income Security Act (ERISA) in an effort to safeguard pensions and disability plans for workers. Unfortunately, workers who need to claim disability benefits that fall under ERISA law are up against strict policies that lean in favor of the insurance company.
ERISA law is highly complex, and ERISA cases are different from private disability insurance cases. Experienced legal representation can positively shape the outcome of your case. Disputed claims must be appealed in federal court – and without a properly completed appeal, you may not bring a lawsuit. If a lawsuit is pursued, your case is usually not allowed a jury trial, but is instead reviewed by a judge.
Legal Representation of Denied Colonial Life Disability Claims
To learn more about your legal rights concerning your Colonial disability claims denial, our firm is ready to provide you with the information you need. Whether you are facing the initial denial, or you just need answers, simply contact our ERISA claim attorneys.
Marc Whitehead & Associates can represent you fairly and capably. Our attorneys posses extensive knowledge of ERISA law and the insurance industry. We have a deep understanding of the disabling conditions our clients are forced to endure.
As disability lawyers, we commit each day to protecting the rights of the disabled. We will work to secure the maximum disability income you need for your family. Call us today at 800-562-9830.
