Long Term Disability
Long Term Disability Insurance (commonly referred to as LTD) is private insurance purchased by an individual or his/her employer. For a person diagnosed with a disabling condition, this coverage should be a priority. LTD is contract-based, meaning that the terms of the contract specify what coverage is provided, the requirements to obtain disability benefits and the amount of financial assistance provided. Most policies provide for payments of between 60 and 80 percent of the claimant’s pre-disability income.
Should your insurance company deny your claim for benefits, it is incredibly important to obtain representation. Many insurers encourage claimants to simply submit a letter for their appeal. They do not advise claimants, however, that there are only one or two opportunities for appeal, and that no additional records can be submitted once these appeals are exhausted. Simply put, if you file your own appeal, your attorney may not be able to give the court anything new if you are denied again and a lawsuit is necessary.
Most claimants are denied benefits either at the time of their initial claim, or after two years of benefits. The majority of insurance contracts change the standard for disability after two years of benefits have been paid. At this time, instead of considering only your past work, the insurer will consider your ability to perform many types of employment.
Insurers will typically have a doctor or nurse review your file before issuing a denial. We have found that these reviews are often not conducted by doctors specializing in your condition and that the reviews conducted are not always thorough and honest.
Finally, when a denial is issued, there are very specific time periods for appeal. Because it takes a considerable amount of time to review the claim file and gather supporting records, you should promptly contact counsel if you receive a denial.
If you have been denied LTD benefits, we encourage you to contact our office to discuss a possible appeal. As always, there is no cost or obligation for an initial call. We can be reached at (610)570-5253 or jhall@jrhlegal.com.
We have previously handled Long Term Disability claims against numerous insurers, including Unum, Cigna, the Hartford, Sun Life, Reliance Standard, Met Life, Mutual of Omaha, The Standard, Aetna, Liberty Mutual, Colonial Life, Aflac, Mass Mutual, Prudential, and Assurant.