Disability Insurance Claims

Today’s video outlines the possible outcomes of a disability case under ERISA law.  Resolving your group disability claim may encompass any of the following: Most group LTD claims are denied either initially or on appeal. Does resolving your group disability claim mean you’re destined to appeal your claim or file suit? There is a better …

In the video above, disability attorney Marc Whitehead discusses the importance of negotiating disability settlement offers. When we explain how disability insurance companies often try to settle claims far below their actual worth, the value of negotiations becomes clear. Our attorneys often work with people whose long term disability claims have been approved, yet they …

In our video above, disability attorney Marc Whitehead discusses the importance of the administrative appeal in group disability claims.
Group insurance plans are governed by federal ERISA law. There are key differences between what you must do to prevail in a claim for group disability benefits under ERISA rules, versus the state contract laws that you would follow if your claim were filed under a private long term disability policy.

Long term disability insurance for employees is regulated by federal ERISA law. As shown in our video above, it is clear that ERISA denies due process in group disability claims – allowing insurers to deny you the benefits you deserve.
What exactly is “due process” as it applies to disability insurance benefits? Due process of law refers to the constitutional guarantee to all persons of fair treatment through the normal judicial system. It is a basic principle of fairness in legal matters, especially in the courts.

Has your group disability claim been denied? If so, you need to know that your claim is governed by the federal law known as ERISA. Not only does this limit your lawsuit causes of action; ERISA limits legal remedies in response to the insurance company’s violations.
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In this video, disability attorney Marc Whitehead explains how LTD insurers will use ERISA law to their advantage to deny your disability claim. It is actually the lack of legal remedies available in ERISA-based cases that hurts claimants—and the insurance companies are fully prepared to capitalize on that.

The ban on discretionary clauses in long term disability insurance plans has been going on for years, with more states pushing for change.

In addition to Texas, many states have amended their state insurance codes to limit or ban the use of discretionary clauses in both individual disability and group disability insurance policies.

What awards can you expect in ERISA settlements or court decisions, if you appeal a long term disability denial and win against your insurance company? As the above video explains, the money coming to you is limited, because there are no compensatory or punitive damage remedies available in ERISA cases.
This is not implying that ERISA settlements or court decisions are paltry; indeed they can produce substantial monetary payments that mean the difference between living disabled in financial ruin or with a secure and stable future. But when compared to other types of court cases, ERISA-based claim awards are limited for insureds.

As our video explains, a wrongly denied individual disability income claim is not fettered by federal ERISA law. If your disability insurance policy is one you bought and paid for yourself, things are much more in your favor. You have many more legal remedies available to you when there is a dispute.
Also referred to as individual disability insurance (IDI), disability income protection and private disability insurance, these policies are not part of an employee benefits package. They are purchased independently from an insurance broker by self-employed professionals such as doctors, dentists, architects, executives – any lucrative profession where an employer or professional association does not provide group disability coverage. [Link to article, Individual Disability Insurance Denials]

In ERISA disability lawsuits, the insurance company (defendant) will not face a jury. In fact, as the video explains, if your claim continues to be denied on appeal and your case goes to Court, in most cases you will not be entitled to a trial at all.
No jury will be able to hear your live testimony, or your doctor’s confirmation of your disabling condition, or a vocational expert’s validation of your inability to perform any occupation.

If you ultimately win a disability dispute, you might think the insurance company will be instructed to pay the attorney fees, even in ERISA disability claims.
However, that is not how it usually goes. This video describes yet another way ERISA disability claimants must fight an uphill battle