Long Term Disability

When a person becomes disabled from working due to an injury or illness, the strain on the disabled victim is tremendous. Unfortunately, disabled individuals with long-term disability insurance, are often shocked at their insurer’s outright refusal to pay benefits. That’s when you need an experienced ERISA attorney to fight for you.

Long term disability insurance claims are often denied – unfairly and without good reason, prompting a respected federal judge to say: “WHEN YOU BUY AN INSURANCE POLICY LIKE THIS, YOU ARE PURCHASING AN INVITATION TO A LEGAL RITUAL…AND YOU WILL BE DENIED BENEFITS.”

In other words, most disability insurance policies inherently favor the insurer. The applicable law is, likewise, unfavorable to the insured. However, an experienced disability attorney can successfully fight and reverse an unfair disability claim.

At the Law Offices of J. Price McNamara, we have been fighting for disabled individuals for over a decade, winning successful trial verdicts and settlements for our clients.

Long-term Disability Insurance Companies

Long term disability insurance companies are corporations whose goal is profit. After they receive insurance premiums from their insureds, they maximize their profits by minimizing what they pay in claims. The more they pay, the less they profit. After collecting premium payments for years, they often refuse to uphold their end of the policy when an insured becomes disabled.

Thus, the disability insurance company collects premiums from you as long as possible, then will often deny your claim no matter how legitimate it may be once you become disabled and need benefits. They may even initially approve you for short term disability (STD) or long term disability (LTD) only to buy time while gathering information in an effort to later deny your claim.

In many cases, policyholders do not fight back despite being unfairly denied their benefits. They believe that the fight may be too costly, and likely unsuccessful. However, of those disabled who do fight back, many will win.

Long-term Disability Insurance Policies

In order to be entitled to disability benefits, you must meet the insurance company’s policy definition of “disability.” The definition of “disability” varies from policy to policy. You will need to consult an ERISA attorney to find out if you have a case. Even if you are found to be totally and permanently disabled in a Social Security disability claim, this does not automatically mean that you meet the disability insurance company’s definition of “disability.”

Disability Insurance Claims Process

Disability insurance companies may deny claims based on technicalities. The insurance companies will use their own paid medical consultants to provide input despite never having met you. These insurance company medical consultants will often even disagree with your own treating physician who sees you on a regular basis. Then the insurance company will often accept its own medical consultant’s opinion regarding disability and disregard the opinion of your treating physician completely.

The insurance company will also ask you to sign forms authorizing the collection of personal information. They will even hire private investigators to investigate, follow, and take video of you to destroy your disability claim. The disability insurers will often use your signed authorization forms to collect medical and other personal records dating back years and years prior to your disability to support any conceivable argument to deny your claim, invading your personal privacy and exposing background information that is absolutely unrelated to your disability. Hire an ERISA attorney as soon as possible.

Even if you know without question that you cannot continue working, the disability insurance company will consider your opinion worthless. As noted above, they will even disregard your physician’s opinions regarding your disability in favor of their own hired consultants. The insurance company’s decision to deny your claim depends on a claims examiner who has no formal medical training whatsoever.

ERISA

The Employee Retirement Income Security Act of 1974, commonly known as ERISA, is a federal law that often controls long term disability claims when the long term disability coverage is provided through one’s employer rather than a private long term disability insurance policy.

When ERISA governs a disabled person’s claim, the disabled claimant is at a disadvantage while the insurance company benefits.

When to Hire an Attorney

Many people do not even think of hiring an attorney until they are denied long term disability benefits. If you are denied long term disability benefits, the best time to hire an ERISA attorney is immediately, BEFORE AN ADMINISTRATIVE APPEAL OF THE CLAIM. An ERISA attorney experienced in long term disability insurance and ERISA claims gathers and provides the evidence required to maximize the chances of winning the administrative appeal.

Our Fees

We answer any questions you have FREE OF CHARGE. Our firm welcomes telephone calls or the opportunity to visit you in person to answer any questions you may have. We also provide free comprehensive case reviews. There is no obligation whatsoever to hire us as your ERISA attorney.

If you ultimately decide to hire us, wrongful death or disability insurance claim, we handle them on a contingent fee basis. We receive compensation only if you win. Our clients owe us nothing, no fee and no reimbursement of our advanced litigation costs, unless we recover.

Mr. McNamara holds the highest possible peer review rating of “AV” (“Very High to Pre-Eminent”) for professional excellence and ethical standards.