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January 2018 Archives

LTD claim denials lead to complicated appeals process

Being unable to work because of an illness or injury is something many in California do not like to consider. However, those with foresight plan for that possibility by adding long-term disability to the insurance benefits they obtain through their employers. Because these policies are often offered as part of an employee benefits package, they are usually subject to ERISA (the Employee Retirement Income Security Act), which governs most employee benefits litigation. ERISA and the associated Department of Labor regulations also govern the process of administratively appealing the denial of a claim for disability benefits which is normally required prior to a lawsuit being filed.

Long-term disability claims are complicated

When illnesses or injuries prevent California workers from performing the duties required on the job, they may be grateful to have long-term disability insurance policies. These policies may come through employers or be purchased privately. However, it is not as easy as simply asking for funds to carry them through the time when they are unable to work. Filing a disability claim is complicated, and appealing a denial may be equally stressful.

How long does an insurance company have to pay a claim?

When you are making a long-term disability claim, your expectation is probably that the insurer will handle the claim in a timely manner. But insurers often fail to support claimants as promised. Insurers make money by keeping claim settlements low and monthly premiums high, so protecting their bottom line is top priority. Even if a settlement has been reached, an insurer may attempt to drag its feet when it comes time to paying out what was agreed upon.

Long-term disability insurance provides security

An injury or sudden illness can send a family's finances into a tailspin. Recovering from such an event may be even more difficult with the stress of unpaid bills and lost wages. The U.S. Occupational Safety and Health Administration estimates that each month, thousands of workers suffer injuries that require months of recovery. While those in California whose employers carry long-term disability insurance may benefit from that coverage, it isn't always easy to obtain those funds.

4 reasons insurance companies deny long-term disability claims

Long-term disability insurance is designed to give you peace of mind by providing monthly income if you become unable to work. Individuals with an employer-based disability plan expect to receive benefits if they're needed.


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Roboostoff & Kalkin, A Professional Law Corporation

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