ERISA Experience You Can Rely On.

Appealing Denied Long-Term Disability And Insurance Claims

Filing an appeal to get a disability or life insurance claim approved or reinstated comes with a lot of red tape. You need to have the information necessary to prove your claim included in the long-term disability appeal. Having an attorney who knows what to look for can give you the advantage you need.

The lawyers here at ERISA Law Center in Fresno know what steps you need to take to get a positive possible outcome in your case. Robert J. Rosati and Raquel M. Busani, our long-term disability attorneys, work diligently to help our clients understand the process. Our skilled team has succeeded in hundreds of cases for our clients. We serve clients across the nation and make ourselves available during all hours of the day.

Understanding Long-Term Disability Benefits And Coverage

Long-term disability benefits can replace income lost after a sickness or injury has made a person unable to work. Unlike Social Security Disability benefits or state disability benefits, the government does not provide short- and long-term disability benefits. Instead, employers offer private short- and long-term disability benefits as a benefit or individual consumers purchase them privately. These policies usually fall under the Employee Retirement Income Security Act of 1974 (ERISA).

Why Was My Claim Denied?

There are many reasons why an insurance provider might deny a claim. Insurance companies usually instruct policyholders to fill out the appeal form and submit it. They do not specify that you need detailed and extensive documentation to support your claim. If the insurer can find medical records or other evidence that conflict with the application, it will usually deny the claim.

What Is The Long-Term Disability Appeal Process Like?

Before filing a lawsuit, you need to file an administrative appeal required under ERISA regulations. Without doing this, you cannot file a lawsuit for any denial or termination that you have experienced. The process of submitting a disability or life insurance appeal is far from short. The steps include:

  1. Review your insurance plan’s ERISA appeal instructions.
  2. Gather additional medical records and other documentation.
  3. Write an ERISA appeal letter.
  4. Submit your appeal within 180 days of receiving your denial.

Thankfully, with over 35 years of experience, our attorneys can help make the life insurance and long-term disability appeals process as smooth as possible.

What Do I Do After My Claim Has Been Denied?

The first thing you should do if your insurance provider denies your long-term disability claim or life insurance claim is to hire an ERISA lawyer. Because ERISA and bad faith cases can be highly complex, people whose disability or life insurance benefits have been denied should contact experienced legal advocacy as soon as possible. When you choose to work with our team, we will provide you with:

  • A legal team that is ready to fight for your rights and future
  • A legal team that is backed by years of experience
  • An accessible legal team that cares for our clients

If your insurance provider denies your appeal, you may have the grounds for a lawsuit. In this case, you will still need knowledgeable insurance law counsel. However, it is always better to put forth a strong appeal the first time around.

How Can We Help When Your Life Insurance Claim Is Denied?

We like to believe that an insurance company will stand behind a life insurance policy it has issued. It seems almost unthinkable that when we have suffered the loss of a loved one, we could then be told that the life insurance policy is not valid. Unfortunately, in too many cases, surviving family members find themselves in this situation.

If the insurance company denied your life insurance, our life insurance attorneys are  experienced in helping our clients obtain their life insurance benefits. As your life insurance attorneys, we can help you fight that denial and get you the benefits you deserve. We may show that:

  • A death was accidental
  • The insured did not contribute to his or her own death
  • Circumstances are sufficiently unclear as to warrant denying a reasonable settlement
  • The insurance policy was incontestable
  • An alleged misstatement on the application involved ignorance
  • The insurance company could have uncovered the health condition through its own physical exam and investigation at the time of the application

Whatever the reason for a denied claim, we will aggressively search for a solution. Our attorneys will work with you and communicate frequently to help you recover your benefits.

Set Up Your Consultation With An ERISA Attorney

If you are struggling with how to appeal a long-term disability denial, you do not have to go through it alone. Contact one of our lawyers. Please call us at 866-360-0983, 559-549-6490 or send us an email for a case review. From our office in California, we handle throughout the 9th Circuit, which includes Arizona, Oregon, Washington, Hawaii and Nevada. Our office is available by phone 24/7 and Zoom by appointment.