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Disability And Other Complex Insurance Claims Pursued Diligently By Tough, Veteran Lawyers

A couple pushes and elderly woman in a wheelchair down a park path

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 New Jersey and New York long-term disability lawyer practiced in such complex insurance claims. If you are about to file a disability insurance claim, or if your claim has been stalled or rejected, contact a disability attorney in our firm today.  At Uscher, Quiat, Uscher & Russo, P.C., we handle wrongful denial of disability, long-term care and life insurance claims, under New Jersey and New York disability insurance law and ERISA, and we have been doing so for more than 35 years, prevailing against all the major carriers.

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. On the positive side, Mike Quiat and his staff have fewer companies to deal with, and they are well-aware of the specific tactics these companies use to deny or deny otherwise legitimate disability claims. We 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 generally offered in group plans through employers under ERISA, or they are offered through private individual policies purchased directly by individuals from insurance agents or brokers. Many policyholders seeking to protect their incomes in the event of medical disasters choose private plans because they typically offer better benefits than an employer-sponsored ERISA plan, or because the insured policyholders are self-employed. Others supplement group coverage covered by ERISA 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, the harsh reality is that some insurers deny a large number of claims, whether or not they are valid, and since some people will never challenge such denials, those people are left without substantial financial benefits to which they are entitled.

Even if you have established a long-term disability claim and are receiving benefits, insurance companies are always looking for ways to save money by buying out claims and negotiating settlements on terms beneficial to them but not 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.

Of course, if internal administrative appeals do not result in payment of disability benefits, the attorneys at Uscher, Quiat, Uscher & Russo, P.C. are always ready 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, including “bad faith” law. Also, unlike ERISA disability claims, where claimants may have limited rights, plaintiffs in private disability insurance cases have full legal rights, including trial by jury.

 

To prevail in a disability claim, you must:

  • Prove the existence of a disability, which is the injury or illness from which you suffer
  • Demonstrate precisely how and why the disability prevents you from performing your job

One of the key to proving the nature and extent of your disability and how it restricts and limits your occupation lies in the hands of your physician, who will be required to complete detailed Attending Physician Statements (APS), which identify the condition(s) from when you suffer and explain how the conditions preclude you from doing your work. APS forms require special and knowledgeable attention.  Certain language is critical and requires a broad understanding of how the insurance company will evaluate your claim. The existence of an illness or injury alone is not enough. You must demonstrate how that injury or illness restricts and limits your ability to perform the substantial and material functions of your job.

Also key to proving disability is the definition of the word in your policy. If the definition in your policy is “own occupation,” then benefits will be paid 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 be paid only if you are unable to perform “any occupation.”

Many policies have changing definitions of disability, starting out as “own occupation” policies and shifting after a certain period of time to “any occupation.”

Uscher, Quiat, Uscher & Russo, P.C., will carefully examine the specific terms and conditions 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 New Jersey Long-Term Disability Lawyer

Contact disability insurance dispute lawyer at Uscher, Quiat, Uscher & Russo, P.C., by calling 201-781-5645 or send an email to discuss your disability insurance claim today. We are dedicated to responsive and knowledgeable legal representation, and will answer your inquiry promptly and keep you informed and involved throughout the process.