Appealing Denied Long-Term Disability Claims in Carrollton
Long-term disability (LTD) insurance provides benefits to those who become disabled and cannot work for long periods of time. Although filing a claim for benefits can often be tedious as insurers required a variety of information from the applicant, their employer, and their healthcare provider, the application itself can be fairly straightforward. Contact a compassionate disability lawyer about whether to begin appealing denied long-term disability claims in Carrollton.
It would make sense that most long-term disability claims are simply approved once an insurance company has the information it needs. However, that is rarely the case. In fact, many insurers simply find ways to deny coverage – hoping that claimants will simply accept the denial without more.
Appealing Disability Denials
Whether someone has a private long-term disability policy or one through an employer which is governed by federal law, appealing denied long-term disability claims in Carrollton makes sense as most insurance companies have separate departments who handle initial claims versus appeals – so different eyes are looking at the information.
In most cases, insurance companies must provide insureds at least 60 days to file an appeal. It is critical to file appeals on time as failing to do so provides the insurance company with an opportunity to deny the claim a second time.
When beginning the appeal process, it is always a good idea to request a copy of the insurance file so that both insurer and insured are looking at the same documents. Most insurers will send a copy, but make sure that request is in writing and keep a copy.
Reviewing the denial letter in its entirety should always be step one. The letter should specify why a claim was denied and explain what an applicant must do to appeal that decision. In some cases, a form may have been missing from the initial application. In others, the insurance company may dispute a statement from the applicant’s employer or healthcare professional.
What is the ERISA Act?
Those who have long-term disability plans through an employer will likely be governed by ERISA (the Employee Retirement Income Security Act). Under ERISA, those denied benefits must exhaust their administrative appeals before going to court. However, it is important to understand that judges in ERISA cases are limited to considering only the evidence that was in an applicant’s file. So, having a copy of the file is crucial at this point.
How an Attorney Can Help
Whatever type of appeal an applicant faces, this is the time to make sure every detail of the denial is rectified. Check and double check that everything missing is now included. Do this as soon as possible because anything missing from a doctor or employer will have to be requested and applicants have little control on how fast this information.
The bottom line is that anyone who has long-term disability insurance and suffers a valid disability is entitled to receive the benefits they were promised based on the policy at issue. Whether achieving that requires an appeal, hiring a lawyer, or being extra vigilant in managing the process, getting the benefits one deserves can make all the difference to families who are already trying to deal with disabilities and financial burdens.
When to call an attorney about appealing denied long-term disability claims in Carrollton can vary case by case and likely depend on the complexity of the issues. The level of the applicant’s frustration can also impact when they decide to reach out. Whatever the case may be, a long-term disability lawyer can take over and deal with insurance companies, doctors, employers, courts, and everything else.
