Diligent Representation For Disability Claims
Last updated on July 17, 2024
Private disability insurance is sold as protection in the event of long-term injury or illness. However, when the time comes to file a claim, you may need protection from your own insurance company!
The best way to get this protection is to contact an experienced disability insurance dispute lawyer practiced in insurance claims. If you are about to file a disability insurance claim, or if your claim has been stalled or rejected, contact our disability attorneys at Uscher, Quiat, Uscher & Russo, P.C., We handle wrongful denial of disability claims under New Jersey and New York disability insurance law and ERISA. We offer more than 35 years of experience taking on large insurance companies.
The Bigger They Are …
Not all insurance carriers provide private long-term disability insurance. This is both good and bad for the policyholders. The downside is that the near-monopoly that companies like Unum, Prudential, MetLife, Hartford, AIG, Aetna, Lincoln Financial, Guardian, Berkshire, United of Omaha, Principal, Northwestern Mutual, Cigna and others have afforded them immense power to deny claims. Our attorneys and staff are well-aware of the tactics these companies commonly use to deny and/or delay otherwise legitimate disability claims. Uscher, Quiat, Uscher & Russo, P.C. have developed our own effective strategies for compelling disability insurers to own up to the full legal obligations they owe their policyholders.
Private Disability Insurance Claims
Long-term disability insurance is mostly offered in group plans through employers. These plans are governed by ERISA, which is a federal law that preempts most state laws. Disability insurance is also offered through private individual policies purchased directly by individuals. Many policyholders seeking to protect their incomes in the event of medical disasters choose private individual policies through an insurance agent or broker because they typically offer better benefits than an employer-sponsored plan but individual plans are also much more expensive. Some people supplement ERISA group policies with private individual disability insurance policies to cover as many bases as possible.
Disability insurance replaces all or part of your earnings if you become unable to work because of a disabling injury or long-term illness, regardless of whether the illness or injury is work-related. However, your disability claim faces an insurance industry which is profit-driven to deny claims wherever possible. Some insurers have well-deserved reputations for questionable claims handling practices.
Even if you have an established long-term disability claim and are receiving benefits, insurance companies are always looking for ways to generate money by buying out claims and negotiating settlements on terms that are beneficial to them but not always beneficial for claimants. Claimants need a knowledgeable advocate in their corner to help them through the complex details of a buyout and to make sure they get their fair share of the benefits.
When all else fails, we do not hesitate to litigate. It doesn’t matter whether the litigation is in federal or state court. We are very familiar with all New Jersey and New York disability insurance laws. We know what “bad faith” is and what you must prove to establish it. Also, unlike ERISA disability claims, where claimants have much more limited rights, plaintiffs in private disability cases have the full array of legal rights, including trial by jury and comprehensive discovery.
To prevail in a disability claim, you must:
- Prove the cause of the disability, which is the injury or illness from which you suffer
- Demonstrate that the disability prevents you from performing your work. This requires medically imposed “restrictions and limitations” which your doctor must impose in order to demonstrate that you cannot do your work.
Usually, the key to proving the nature and extent of your disability and how it applies to your occupation lies in the hands of your physician. Your disability claim forms require special and knowledgeable attention. In addition, it’s vitally important to your disability claim that the information you file is complete, accurate and relevant. Don’t start off on the wrong foot in making your disability claim.
Rely on our disability resources to learn more about your situation
- To understand the nuances of disability law
- Frequently asked questions during the claims process
Also key to proving disability is the definition of “disability” in your policy. If the definition in your policy is “own occupation,” then you will receive benefits if you are disabled to the point where you cannot perform your “own occupation” (occupation-specific disability). If the definition is “any occupation,” then you will receive benefits if you are unable to perform “any occupation.”
You must know the requirements of your particular policy before you ever file a claim; you do not want to learn about the requirements of your policy only after your claim has been denied.
How To Avoid Bad Faith Tactics In A Long-Term Disability Insurance Claim
Disability insurance can be very useful. Statistics show that many people become disabled long term before they reach retirement. However, disability insurance is big business, and like any other profit-making venture, there are some unscrupulous “players”. It is very important that you work with a New Jersey and New York long-term disability attorney in order to avoid the bad faith tactics of an insurance company.
The following are examples of how insurance companies can act in bad faith:
- They do not properly or honestly investigate a valid claim.
- They pay an amount substantially lower than that required by the policy.
- They delay payments or deny them altogether, and for invalid reasons.
Take Precautions To Prevent Insurance Dishonesty
When you work with a long-term disability company, taking certain precautions can help guard you against such tactics. These include:
- Making sure to research the company before signing any documents
- Asking questions in order to make sure you understand what the company claims it will provide
- Asking how long the benefits will last and how soon after a claim is submitted will the company begin paying out
- Asking how much of your salary, by percentage, will be paid out in disability payments
- Finding out whether there is a waiting period after signing up before you can collect disability
- Going over the policy with your attorney to determine whether it reflects practices standard to the industry
- Reviewing the policy carefully before signing
Don’t Do This Alone, Contact Our Disability Insurance Dispute Lawyers
Uscher, Quiat, Uscher & Russo, P.C. will examine the terms and exclusions of your policy and advise on the viability of your disability claim. It may be as simple as getting a doctor to certify your disability, or there may be complex legal issues that could go either way in court. In any case, you are assured of honest legal counsel and aggressive representation by an experienced professional in just the area you need – disability insurance law.
Contact our disability insurance dispute lawyers at 201-781-5645 to discuss your disability claim today. We are dedicated to responsive and knowledgeable legal representation. We will answer your inquiry promptly and keep you informed and involved throughout the process.