Q. I paid for an insurance policy in case I became disabled. Now I can’t work due to health problems. My doctor is on my side but the insurance company won’t pay. What do I do?
Jennifer, Colbert Heights
A. The law is different if your policy was paid for or purchased through your employer. If it was, then you have to follow all the administrative procedures under a federal law known as ERISA. What that means is that if they ask for something else, like an additional form, get it for them. If you receive a formal denial in these cases you only have 180 days to file an appeal. You must talk to a lawyer if you are denied in writing.
If, on the other hand, you paid for your policy outside of your employment or you are a governmental employee (Congress exempted themselves and other government employees from this very bad law) call a lawyer now. My law firm handles these matters as do others. Ask if the law firm you hire handles LTD (Long Term Disability) cases. Whether you call us or someone else, call a lawyer for assistance as these cases are complicated but winnable.
Insurance companies profit when they deny your claim. They are in business for profit and have been found guilty time after time of unfairly denying claims that should have been paid. Insurance companies often put their interest first even when it is against their own rules. These cases deal with what doctors say and often the insurance company will hire a doctor to review your claim. These non-treating physicians will render opinions in favor of the insurance company about people they have never treated to deny long term disability claims. Sometimes they win, but when your doctor is on your side that goes a long way towards your case.
Buckle up, drive safely and as always your referrals are appreciated! 256-764-0112
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