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Too much is at stake to guess about the best approach and strategy for fighting your denied insurance claim — years and years of financial security.
After spending years representing insurance companies, we don’t guess. We know their playbook and how they work behind the scenes. Using that knowledge, we’ve developed our own Clear Advantage Process for fighting claims.
It’s personally satisfying to use what I’ve learned as an insurance company insider, now for the good — helping families reverse unfair denials of insurance benefits they paid for, need and deserve.
The Employee Retirement Income Security Act of 1974, which is also known as ERISA, controls the majority of employer-sponsored insurance plans that cover disability benefits. In many instances, insurance companies will try and deny a claim for disability benefits. In fact, a first-time denial is not really all that unusual. In many instances, you may need to appeal at least once in order to receive the disability benefits that you deserve.
There are many reasons why insurance companies deny disability benefit claims. In many cases, the insurance company will argue that there is insufficient medical documentation to show that the benefits applicant is incapable of working.
If your claim for disability benefits has been denied, the knowledgeable team of disability insurance denial lawyers in Austin at the Law Offices of J. Price McNamara may be able to assist.
One of the main reasons why disability benefit claims are denied is because of insufficient medical documentation. Specifically, to be successful with your claim, the medical documentation must support that the claimant suffers from an illness or injury that is long-term and prevents him or her from performing any type of work – in any capacity.
In order to be successful with proving your case, you need to have a healthcare provider on board who is ready to state, to a reasonable degree of medical certainty, that your injury or illness does not allow you to do any type of work.
If your insurance company decides to deny your disability benefits claim, it must send you a letter that states exactly why your claim is being denied. The letter must also explain the process that you must go through in order to appeal your claim denial.
The first step in the appeals process is typically to file an administrative appeal with your insurance company. These appeals are handled in-house, and if you submit new documentation, including new medical documentation, the insurance company will review it.
Once you have exhausted the administrative appeals process, if you are still seeking benefits, you have the option of filing a complaint against the insurance company in the federal court system. A federal judge will decide the case outcome. In these types of cases, you are not entitled to a jury trial in the federal court system.
An experienced disability insurance denial attorney in Austin can assist you with determining why your disability claim was denied, and if necessary, can assist you with filing your appeal.
The legal team at the Law Offices of J. Price McNamara is ready to assist you with responding to your disability insurance benefits denial and with filing an administrative appeal (and a federal court appeal, if necessary) on your behalf.
To schedule a free case evaluation and legal consultation with an experienced disability insurance denial attorney in Austin, please contact us online today.
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