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If you are unable to work due to a disability and your employer provides long term disability insurance, there are important legal protections in place to help you. For many professionals, including medical, legal, and technical workers, this insurance is a critical safety net. Employer-sponsored plans must meet certain standards, especially if governed by the Employee Retirement Income Security Act of 1974 (ERISA), which applies to most plans provided or offered through employment.
Many insurers take advantage of the rules meant to protect you to deny your claim. They use technicalities to stall or deny claims, leaving you disabled and wondering how to appeal your denial. When this happens, it is important to consult a Clearwater long term disability insurance lawyer.
Although based in Pinellas County, we handle disability cases across the country. During a complimentary consultation at Herman & Wells, our disability dispute attorneys can determine if your denial is wrongful and discuss our options to help you.
Among other functions, ERISA governs most employer-sponsored disability, life, accidental death and dismemberment (AD&D), and retirement plans.
When an employer wishes to offer disability benefits, ERISA affects:
The company’s insurer must notify an employee by mail when a claim is denied. This notification should explain, in detail, the reason for the denial, the policy provisions the denial is based on, and an employee’s rights under ERISA, including the appeal process.
The appeal process is the most critical part of an ERISA disability claim. If the appeal is not done correctly, it will eliminate any chance of winning or of any recovery. Do not appeal on your own; have an attorney help you.
If you need guidance applying for benefits or appealing a denial, Herman & Wells can help you. Our Clearwater attorneys can assist with the appeal to ensure the appeal is done correctly and all the necessary information is included.
Employees who qualify for disability under an ERISA plan usually receive between 50 and 60 percent of their wages. A Clearwater attorney experienced in long term disability insurance can help you navigate this complicated process.
If you are not eligible for long term disability insurance through an employer or your employer does not offer it, you can purchase private coverage individually or through a group disability coverage plan. An individual plan is common for those who are self-employed, or wish to supplement an employer’s plan when it is offered. Individual policies do not fall under ERISA oversight, but are regulated by Florida law.
Group disability insurance is purchased through a third-party, such as a trade organization that you belong to, an automobile club, or a civic organization. Group disability insurance is also regulated by Florida law instead of ERISA.
Providers of these policies can also deny claims even for technical errors, which is why it is important to consult with the Clearwater long term disability insurance lawyers at Herman & Wells to ensure your claim is complete or an appeal is handled properly.
Often, an insurer’s denial of a disability claim is due to a technicality or lack of specific information. However, the information that is lacking is not all the information that is needed in an appeal. With their extensive experience, our attorneys ensure your appeal is handled properly and remove the need for you to communicate with the insurance company.
We take the time to listen to you and stay in touch, so you are updated when we are. You are never just a number at Herman & Wells; you are valued, and we’re honored to serve your legal needs. Call now to schedule a complimentary consultation with a Clearwater long term disability insurance lawyer.
