There are laws “on the books” meant to guarantee your long-term disability insurance will be there for you if you’re unable to work due to a health problem. But too often, laws are one thing and business is another.
A Chicago CBS affiliate recently profiled Glenn, a senior vice president at a prestigious interior design magazine until his heart condition made it impossible to continue his career. According to the profile, an insurance company denied his claim by saying simply that he actually could keep working, despite what his doctors say.
Quintuple bypass and multiple heart attacks not enough
Today, Glenn sometimes loses his breath just from making breakfast. He says he loved his job but found himself having to hide his chest pains while talking to clients. He wasn’t always sure he would make it through presentations, and his heart forced him to retire early, according to the CBS story.
He’s had two heart attacks and is at high risk for a third. His doctors found the state of his heart justified five-way bypass surgery. They consider their patient to be permanently disabled.
Insurance company disagrees with doctors and evidence
The insurance company argues that there is “no evidence” that being a senior vice president at a major publication “involves more than occasional standing and walking,” as quoted by the report.
Glenn’s counsel diagnoses the problems as insurance companies deliberately denying payment until the customer settles for a tiny fraction of the insurance they actually paid for.
It’s a question of people being worn down by an entity that doesn’t get worn down, counsel says. Insurance companies don’t get financially and emotionally stress. Businesses don’t have heart attacks. All too often, the only way to counter such a business model is to remember that the law can work for you.
Fighting back against denial of long-term disability
The Employee Retirement Income Security Act (ERISA), which this year marks 45 years of protecting America’s workers, requires employee-sponsored disability insurance to meet its obligations.
Unfortunately, Glenn’s experience with his insurance company is disturbingly common. The profile of Glenn doesn’t specify whether Glenn is fighting the insurance company over an employee-sponsored plan, but it often appears to make little difference to insurers.
ERISA is federal law. If your employer-sponsored insurance provider has denied your disability claim, federal law requires that the insurer needs either to be capable of defending that decision in court or to pay up.