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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.
People take out a long-term disability policy of insurance, many times with an employer, in the hopes that they will have insurance coverage in place if they unexpectedly suffer a permanent illness or injury that prevents them from working. In those instances, the plan is usually covered under the federal ERISA statute.
Unfortunately, long-term disability benefit denials are routine and commonplace. Insurance companies will often look for a reason to deny these claims, and they often point to a lack of sufficient medical documentation as their basis.
Fortunately, if your disability benefits claim has been denied, you will have the opportunity to file an appeal. First, you can file an appeal directly with your insurance company. If that does not work, you have the option of appealing your case in the federal court system by filing a complaint against your insurance company. The experienced team of long term disability appeals attorneys in Arlington at the Law Offices of J. Price McNamara are ready to assist you with your long term disability benefits appeal.
In the event the insurance company decides to deny your claim for disability benefits, for whatever reason, it must tell you why it is taking this action in a denial letter that is sent to you. You and your lawyer should review this letter carefully. The letter will also tell you the time frame during which you can file an administrative appeal. As part of filing your appeal, you may want to attach additional documentation, especially medical records or letters from a healthcare provider, which establish that your injury or illness prevents you from working in any capacity.
Once you file your administrative appeal with the insurance company, it will review all of the additional documentation and make a decision in your case. Insurance companies are required to allow you at least one administrative appeal opportunity, although some insurance companies allow for more than one.
If your administrative appeal or appeals are unsuccessful, you will then have the option of filing a complaint against your insurance company in federal court. Eventually, a formal court hearing will be set in, and a judge will decide the outcome of your case. In federal ERISA cases, you do not have a right to a jury trial. Instead, the court will make the ultimate decision about whether or not you are entitled to receive any disability benefits.
The experienced team of attorneys at the Law Offices of J. Price McNamara can assist you with filing an administrative appeal of your benefits claim denial and/or with filing a federal court appeal, if it becomes necessary. To schedule a free case evaluation and legal consultation with an experienced long term disability appeals attorney in Arlington, please contact us online today.
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