FAQs
Frequently Asked Questions -Disability
Insurance Denials and General Insurance Questions
At DarrasLaw, we protect policyholders from insurance company abuse.
Getting timely payment on any insurance claim is crucial in today’s economy, if you are like most people, you can’t afford the insurance runaround.
The questions answered in this Frequently Asked Questions section, although not intended to be legal advice, should give you fact specific information that may be relevant to your case.
Please review the questions and see if any of our material will help you. If not, please email us at info@darraslaw.com and send us your questions.The DarrasLaw team of experts will answer as quickly as possible.
Feel free to call our office toll free, at any time for free insurance help, policy information, or claim advice at 1-800-458-4577 or Email us at info@darraslaw.com.
Disability FAQs
Q. Do I have to appeal the denial of my disability benefits before I can file a lawsuit?
A. The answer depends on the type of policy you have:
Generally, you do not need to appeal if you have an individual policy purchased through an agent or broker, or if your policy was provided to you by a government or church employer directly (that is, not through a union or employee organization). You may file a lawsuit after your first denial.
If your policy is through a private employer, an employee organization, or a union, the Employee Retirement Income Security Act of 1974 (“ERISA”) requires you to exhaust your administrative remedies before you can file a lawsuit. This means you must follow the insurance company’s internal appeals process. For example, most plan documents only call for one mandatory appeal, but if the plan documents call for two mandatory appeals, you will have to complete two levels of internal appeals before you can sue.
If you are uncertain whether you are required to appeal your denial, you should immediately consult an attorney experienced in handling ERISA disability cases. We may be able to help you. Please contact us at info@darraslaw.com or at 1-800-458-4577.
Q: Why is it so important that I appeal?
A: The Employee Retirement Income Security Act of 1974 (“ERISA”) requires you to exhaust your administrative remedies before you can file a lawsuit. The internal appeal process allows the insurance company an opportunity to correct its mistakes and avoid a lawsuit. If you do not give the insurance company the chance to right its own wrongs first, most courts will not allow your lawsuit to proceed.
The internal appeals process is also a very important opportunity for you, the disabled claimant. It gives you a chance to load your claim file with information supporting your disability claim and to correct any misconceptions. It is imperative that you submit everything that may possibly help prove your disability and your credibility. (See “How do I appeal my own denial of disability benefits?” below.)
Insurance FAQs
Q: What is bad faith insurance denial?
A: Bad faith insurance denials are common in America as carriers try to unreasonably delay or wrongfully deny your legitimate right to your insurance benefits. Delaying, not paying the full amount owed, not promptly, fairly, equitably investigating and evaluating the claim with an eye towards payment are all examples of carrier bad faith. Policyholders often hurt their chances to establish bad faith by giving their insurance company two bites at the claim apple when offered an appeal. In some cases the appeal is mandatory and in others it is not necessary and builds in more time for the carrier to hold onto your benefits. To appeal or not appeal really requires expert top insurance attorney help.
Q: I am 75 years old and cannot live on social security and am running out of savings. I am thinking about selling my life insurance. How do I do this and get what is fair?
A: Senior life settlements are quickly dominating the senior landscape. If you are older and have health problems and could use cash now to assist with your medical care or you are in jeopardy of losing your life insurance due to lapse because you can’t afford the premium or you have enough and just want to enhance your loved ones now or charitably donate the life insurance policy. Make sure you engage an agent with a national company and make sure you get their commission schedule and all bids to buy your policy in writing. The transaction could have tax implications so it’s always a good idea to get top insurance attorney help.
Q: My individual disability insurance claim has been denied, what do I do?
A: Many policyholders make the mistake of trying to appeal on their won when it may not be necessary. Some policies require appeal and policyholders misread, misunderstand or just don’t have enough familiarity with the legal language to know for sure. Contact a top insurance attorney before you make a fatal claim or appeal mistake so you and yours are protected.
Q: How do I file for a disability claim?
A: If you bought the policy from an agent or broker contact them so they can alert the carrier to send you claim forms or contact the carrier directly to get the package of forms. Beware, these forms are tricky, confusing and ask claim ending questions so get some free help from a top disability attorney before sending in any of your forms or filling out crucial paperwork.
