Florida residents who are unable to work for an extended period of time should be able to rely on a long-term disability insurance plan in order to provide some sort of financial security. It can mean the difference between being able to afford your bills or struggling financially during such a difficult time in life.
Unfortunately, sometimes employers or their insurance companies dispute the validity of a disability claim. This can be especially true if the employer-backed long-term disability insurance plan is administered by a third-party administrator. Florida has laws that protect individuals from these types of disputes and it is important to consult with an experienced Florida Disability Claim Dispute Attorney if you feel your claim has been wrongfully denied.
At Herman & Wells, we understand the importance of having long-term disability insurance and the obstacles that can arise when trying to secure benefits from an employer-backed plan. Our experienced Florida disability claims dispute attorneys are here to help ensure you obtain the benefits you deserve. Contact Herman & Wells today for assistance with your long-term disability insurance claim. We are always here to help.
What Is Long Term Disability Insurance?
Long-term disability insurance (LTD) is a type of insurance policy that provides income to individuals who become disabled due to illness or injury and are unable to work for an extended period of time. It can help ease the financial burden that comes with being unable to work and provide you with peace of mind knowing you have some sort of safety net in the event of a disability.
Employer Disability Insurance
Some employers offer long-term disability insurance as part of their benefits package, although the coverage can vary from employer to employer. This type of policy is usually called “group long-term disability insurance” (GLTD) and it is often funded by the employee’s contributions. Group plans are usually more affordable than individual plans, but the coverage may be limited.
Individual Disability Insurance
Individual long-term disability insurance is purchased by an individual on their own, and it is typically more comprehensive than group plans. The cost of individual disability insurance can vary based on a number of factors such as the amount of coverage desired, age at purchase, occupation, health status, and more.
Non-Employer Group Disability Insurance
In Florida, many organizations offer long-term disability insurance to their members. These plans are usually offered by professional associations and can provide decent coverage at an affordable rate.
In Florida, applicants must meet certain eligibility requirements in order to qualify for long-term disability insurance. Generally, you must be 18 years of age or older and have held a full-time job for at least 12 months prior to applying for coverage. You also need to provide proof of Florida residency and you must not have any pre-existing conditions that would make you ineligible.
How Does Long Term Disability Insurance Work In Florida?
Here is a breakdown of how long term disability insurance works:
Florida's long term disability insurance offers a variety of benefit payments, including rehabilitation expenses, medical expenses, and income replacement. The amount of benefit you receive depends on your specific policy and the type of disability you have suffered. Generally speaking, Florida long term disability benefits can cover up to 80 percent of your pre-disability income.
Determining Long Term Disability Benefits
When filing a Florida long term disability claim, your insurance company will review the facts of your individual case and determine the benefits you are eligible to receive. In Florida, most long-term disability policies pay out 50 to 66 percent of your pre-disability income. You may also be entitled to reimbursement for medical bills and other expenses related.
Duration Of Coverage
In Florida, long-term disability insurance may provide coverage for up to five years. However, depending on the terms of your policy and the type of disability you have suffered, benefits may be extended beyond that period.
Exclusions And Limitations
Florida's long term disability policies do have exclusions and limitations, so it is important to understand the terms of your policy before filing a claim. Some common exclusions include pre-existing conditions, mental health disorders, and self-inflicted injuries.
How To File A Long Term Disability Insurance Claim In Florida
Filing an insurance claim can be complicated, so it’s important to understand the process before getting started. In Florida, long term disability claims are regulated by both federal and state laws. Here is a step-by-step guide to help you file an insurance claim:
Gather all necessary documents related to your disability, such as medical records and proof of income. It’s important to provide as much evidence as possible in order to ensure your claim is approved.
Submit Your Long Term Disability Claim
When filing an insurance claim in Florida, it is important to make sure you are submitting your paperwork within the designated timeline. Typically, long term disability claims must be filed within two years of the onset of your disability or injury. Failure to do so may result in a denial of benefits.
Be Cooperative And Patient
Respond to any questions or requests from the insurance company in a timely manner. Depending on the type of disability and other factors, your long term disability claim will be reviewed by a team of experts who will carefully evaluate all of the evidence you have provided to determine your eligibility for benefits. This process can take anywhere from several weeks to several months, so it’s important to remain patient and proactive during this period.
Contact A Disability Claim Dispute Attorney
If your long term disability claim is denied, consider consulting with an experienced Florida-based disability claim dispute attorney who can help you understand the legal process and assist with appeal options if necessary.
Consider Insurance Company Offer
Consider any offers from the insurance company, but keep in mind that if your claim is approved for a long term disability benefit it will likely be lower than the initial amount you requested. Keep detailed records of all communications between you and the insurance company to ensure that your rights are protected throughout the claims process.
Filing a long term disability claim can be complicated and time consuming. Consider consulting with an experienced Florida-based disability claim dispute attorney from the very beginning. They can help you navigate the claims process from start to finish and explain your right to appeal if your claim is denied.
Common Reasons for Denied Long Term Disability Insurance Claims In Florida
There are a number of reasons why Florida long term disability insurance claims can be denied. Understanding these common claim denials can help you determine the next steps to take if your disability claim is denied.
Insufficient Medical Documentation
A Florida disability carrier may deny an LTD claim if there is insufficient medical evidence that demonstrates that you are disabled due to your medical condition. This evidence includes records from your physician and/or other health care providers, as well as statements that confirm your disability status and functional limitations due to the disability.
Sometimes Florida insurance companies may deny disability claims due to a pre-existing condition. A Florida long term disability policy may contain language that excludes coverage for any pre-existing medical condition or limits the benefits available if you have a pre-existing medical condition.
Failure To Follow Treatment Plan
Your Florida long term disability insurance company could deny your claim if it believes that you are not following the treatment plan prescribed by your doctor. The Florida disability insurance company may also deny your claim if it believes that you are not taking appropriate steps to restore or maintain the ability to work.
Inaccurate Representations On Your Florida Disability Insurance Application
If Florida disability carrier finds that you made inaccurate statements on your disability insurance application, your claim may be denied. It’s important to answer all questions in the Florida disability insurance application accurately and completely.
Non-Compliance With The Insurance Company's Request
If Florida disability insurance company requests additional information or documentation and you fail to provide it in a timely manner, your claim may be denied. Florida disability companies have the right to request more information if they believe it will help them make an informed decision about your claim.
Long Term Disability Insurance Rights For Employees In Florida
Employees in Florida have certain rights when it comes to long term disability insurance. If you are injured or become ill and cannot work due to a disability, you may be entitled to long term disability benefits through your employer-sponsored plan.
Employees in Florida who are seeking long term disability benefits have a limited amount of time to file a claim. As mentioned earlier, under Florida law, an employee who has been denied long term disability benefits must file a claim within two years of the denial.
If you have been denied long term disability benefits or are having difficulty getting the insurance company to process the claim, it is strongly recommended that you seek the help of a disability claim dispute attorney.
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FAQs About Long Term Disability Insurance In Florida
Q: What Is The Difference Between Short Term And Long Term Disability Insurance?
A: Short term disability insurance is designed to provide income protection for a short period of time (usually up to 6 months). Long term disability insurance provides coverage for a longer period of time, usually up to two years or more.
Q: How Much Does Long Term Disability Insurance Cost In Florida?
A: The cost of Florida long term disability insurance varies depending on the type of plan you choose. Generally, Florida long term disability policies are more expensive than short-term plans, but they provide significantly more coverage.
Q: What Is The Maximum Amount Of Benefits I Can Receive Under Long Term Disability Insurance?
A: The maximum amount of benefits you can receive under Florida long term disability insurance depends on the type of policy you purchase. Florida long term disability policies typically provide up to two years of coverage, with a maximum benefit amount ranging from $2,000 to $5,000 per month.
Q: Can I Appeal A Denied Long Term Disability Insurance Claim?
A: Yes. If Florida disability insurance company denies your long term disability claim, you have the right to appeal their decision. Florida law allows employees to file an appeal within two years of the initial denial.
Q: How Long Does It Take To Receive Long Term Disability Insurance Benefits In Florida?
A: Florida long term disability claims can take anywhere from several weeks to several months to process. If your Florida disability insurance company requests additional information or documentation and you fail to provide it in a timely manner, your claim may be delayed or denied.
Talk To An Experienced Disability Claim Dispute Attorney
Florida employees with long term disabilities may be entitled to financial benefits from their disability insurance policy. However, the claims process can be complex and time-sensitive. Florida law places strict limits on filing an appeal of a denied claim, so it is critical that Florida employees understand their rights and requirements of Florida long term disability insurance policies. If you’ve been denied long term disability benefits, it is recommended that you contact an experienced Florida disability claim dispute attorney for assistance.
The disability claim dispute attorneys of Herman & Wells are committed to providing Florida employees with the legal guidance and representation they need during the disability claims process. Our experienced attorneys will ensure that your rights are protected throughout the appeals process, and work hard to obtain the benefits you deserve. Contact Herman & Wells today for a free consultation at (727) 821-3195.