Many people in Shreveport reasonably believe that since they pay for long-term disability insurance either through work or on their own, they will receive disability benefit payments to make up for lost wages if they become disabled and are unable to work. So, when the insurer they expect to provide those benefits instead denies their claim, the unexpected lack of benefits can be very discouraging.
However, it is important to remember that insurance is a business, and companies often seek to keep their costs low by denying claims, particularly for benefits that may continue over a long period of time. It is even more important to remember that you have the right to appeal an insurance company’s denial of benefits.
An experienced attorney could assist with the process of handling Shreveport long-term disability insurance denials. They could also help you determine what the process actually entails, since the approach to contesting such rejections often differs depending on the type of disability involved as well as the source of the insurance.
The law treats insurance policies differently depending on how they were purchased. For instance, the federal Employee Retirement Income Security Act of 1974—or ERISA for short—regulates the provision of benefits to employees, including long-term disability insurance and other types of medical coverage.
Under this law, plans must describe information clearly for plan beneficiaries, and they must have a procedure for appealing denials. If the administrative appeal fails to bring about the desired result, the law gives the claimant the right to appeal the decision in federal court.
The procedure for reconsideration when a claim is denied varies depending on the provisions of the policy. Some plans have two stages of appeal, while others only offer one after a Shreveport long-term disability insurance denial.
Either way, it is important to follow the appeal deadlines established in the policy. Even though they are often shorter than the amount of time ordinarily allowed by law, the contractual provisions of the policy will overrule statutory deadlines.
When someone in Shreveport purchases a long-term disability policy on their own or through a non-employment related group, ERISA does not apply. Instead, the provisions of the policy as interpreted under state insurance and contract laws govern the appeal process.
It is usually necessary to appeal a denial first through the insurer before filing a lawsuit in state court. If an insurer’s denial is found to constitute a violation of bad-faith insurance laws, the person seeking benefits may be entitled to receive additional compensation beyond the benefits offered under the policy. Speak with an accomplished lawyer for more information about obtaining disability insurance.
Those seeking to obtain long-term disability benefits generally must obtain and submit vast amounts of persuasive evidence to support their claim. This evidence may pertain to the cause of the medical condition, the severity, and the impact of that condition on the ability to perform any type of paid work.
Many claimants find it helpful to work with an attorney experienced in handling Shreveport long-term disability insurance denials. A knowledgeable ERISA lawyer could assist with preparing and filing forms backed by strong evidence, advocating on behalf of the insured during information negotiations and formal proceedings and analyzing the situation to provide advice throughout the process.
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