In the video above we discuss the insurance company’s tactic of “cherry picking” the records for evidence of your ability to work. This likely means the insurer is suppressing or ignoring evidence of disability as well.
You can call it many things – cherry picking, rejecting inconvenient evidence, selective observation, slanting, dismissing contrary evidence – but it all boils down to ignoring critical evidence. By doing so, an insurer is able to smother the relevant facts that prove you are unable to work.
Ignoring Evidence Is Rampant in ERISA-based Disability Insurance Claims
Ignoring a claimant’s proof of disability often goes hand-in-hand with group disability claims, especially when the insurance company performs paper reviews. A paper review is when the insurer does not take the trouble to conduct a physical exam on the claimant, and merely has their in-house doctor review the records provided in the claim file.
What ensues is a perfect storm against a valid claim for disability benefits. Here’s why:
- Group disability insurance is governed by the Employee Retirement Income Security Act (ERISA). Appeals are controlled by ERISA, and ensuing lawsuits are litigated in Federal court under ERISA.
- ERISA law does not require the insurer to conduct a physical exam, and
- ERISA allows the insurance carrier to base decisions on paper reviews
Because it’s so effective, ignoring evidence of disability and other selective claim handling tactics are present in claims for individual disability insurance (IDI) as well. Treated differently from group claims, disputes regarding IDI policies are governed and litigated under state contract and insurance laws.
Without an experience lawyer in your corner, you will rarely beat a determined insurance company at their game. Disability insurance is a complex area of law that requires skilled legal counsel.
So how do you fight tactics like these?
There are legal strategies we mount to refute ignoring evidence and slanted reviews. First we examine the claim file, to detect and expose procedural mistakes and errors, conflicts of interest, and deception or misrepresentation to undermine the claim.
We take many measures to legally prove a finding of disability. In a narrative that creates the full scope of why you are unable to work, our attorneys bring forward any facts that were previously ignored or suppressed. It is often necessary to produce further medical records, functional capacity evaluations or other assessment of vocational ability that may have been missing from your initial claim.
Do not hesitate to ask our lawyers for help. With so much at stake, you have only a brief window of time to file an appeal.
Is the insurer ignoring evidence of disability? We can help you fight back.
Our law firm represents independent professionals and employees who participate in their employer’s disability insurance plan.
We welcome and encourage your call. You must never give up, but to win the fight you need a disability claim attorney with many years of experience on your side.