FAQs About Employer-Provided Long-Term Disability Insurance Claim Denials

Employer-provided long-term incapacity (LTD) insurance coverage protects you within the occasion an damage or sickness prevents you from working for a 12 months or longer. It usually compensates as much as two-thirds of your misplaced wages, which may present a lifeline for you and your loved ones. Nevertheless, many employer-provided LTD insurance coverage claims typically find yourself getting denied.

As an skilled Orlando long-term incapacity lawyer, we assist individuals with denied LTD claims and shield their rights in submitting an enchantment. The next are among the many most steadily requested questions (FAQs) we hear from our purchasers:

Why Was My Lengthy-Time period Incapacity Declare Denied?

As insurance coverage firms are for-profit companies, it’s of their monetary finest pursuits to keep away from paying out on claims. They could deny your advantages for any of the next causes:

• Errors and errors in your half in filling out an software;
• Administrative errors on their half in processing;
• Disputes over the phrases of protection and whether or not you might be entitled to advantages;
• Disputes over whether or not your situation qualifies and will be categorized as a long-term incapacity;
• Failure to supply applicable documentation;
• Failure to answer requests for added info or different insurance coverage firm necessities.

What Ought to I Do If I Get A Denial Letter? 

You will need to act promptly in the event you obtain any sort of communication from the insurance coverage firm. In case you have been denied long-term incapacity advantages, it is very important fastidiously overview the next:

• The precise causes for the denial, which ought to be cited within the letter;
• The date it was despatched and the period of time given to file an enchantment;
• The phrases of your long-term incapacity protection.

The Worker Retirement Earnings Safety Act of 1974 (ERISA) governs employer-provided profit applications. Below ERISA, you might be entitled to obtain a duplicate of all long-term incapacity insurance coverage coverage paperwork, freed from cost and at your request.

How Do I Enchantment Denied Lengthy-Time period Incapacity Insurance coverage Advantages?

Coping with insurance coverage firms is at all times difficult. Luckily, these firms are required to stick to complicated guidelines and laws beneath the Florida Administrative Code in relation to coping with people they do enterprise with. Nevertheless, as state legal guidelines and insurance coverage firm procedures are sometimes complicated and complicated, it is very important get an skilled long-term incapacity legal professional in your aspect, each in submitting your declare and in any wanted appeals.

The appeals course of includes disputing the insurance coverage firm’s determination and offering proof why your advantages ought to be authorised. This includes:

• Notifying the insurer of your intent to file an enchantment;
• Gathering further proof in help of your declare;
• Showing at administrative hearings and arguing your case earlier than a committee;
• Taking your case to courtroom within the occasion the insurance coverage continues to disclaim your declare.

Contact Our Florida Lengthy-Time period Incapacity Legal professional At this time

At Farrell Incapacity Regulation, we shield your rights in coping with insurance coverage firms and assist you get the LTD advantages you might be entitled to. In case you have been denied advantages, name or contact our Florida long-term incapacity legal professional on-line to request a session in our Orlando or Jacksonville workplace.

Sources:

dol.gov/common/subject/retirement/erisa

flrules.org/gateway/group.asp?id=520