Our veteran New York City disability law attorneys at Seelig Law Offices are dedicated to representing individuals whose disability insurance claims have been denied. Disability insurance is meant to be a safety net in the event that an individual becomes so injured or ill that they are unable to work. Unlike many employer-issued disability benefits, disability insurance can be utilized whether a person is injured on or off the job. This type of insurance is intended to offer peace of mind and financial assistance, following an unfortunate incident or illness.
Unfortunately, even though some individuals pay for this type of protection, they find that after they become disabled, the insurance carrier denies the claim. Our attorneys at Seelig Law Offices are experienced in working with insurance carriers to have these denials reversed and, in the event that a denial is not overturned, bringing disability insurance lawsuits to court.
Disability insurance can be either short term or long term. Short-term disability insurance provides income replacement to the worker for a number of months or years. Long-term disability insurance covers the worker for a much longer duration. The first step in applying for disability coverage is usually an application for short-term benefits. Regardless of the type of policy, the insurer will consider a number of factors when determining if benefits are due.
While these considerations vary from carrier to carrier, they usually include a review of the duration and character of the claimant’s work, among other things. The carrier will then make a decision on whether to pay the claim. Unfortunately, there are instances when these claims are denied for improper reasons, such as a claim of insufficient medical evidence of the disability.
If a claim is denied and the worker feels it was done improperly, the first step is to exhaust the carrier’s internal appeals process. Many times, the representation of an attorney makes a difference in this process. An experienced attorney can present a comprehensive and complete appeal forcing the carrier to review all of the issues. It also shows the carrier that the claimant means business and that they could be facing a lawsuit should they deny the claim again.
Our attorneys at Seelig Law Offices have had great success in this area and have had many disability insurance claim denials reversed at this level. If the appeals process is a dead end and it is determined to be appropriate, a civil lawsuit can be filed against the insurance company.
Disability insurance policies can either be purchased by the individual or by an employer on behalf of the individual. If the employer purchased the policy, the disability case is governed by the Employee Retirement Income Security Act of 1974 (ERISA). ERISA is the federal law that governs all employer-issued disability benefits. As such, cases falling into this category are usually brought in federal court.
Regardless of whether the policy was purchased by the individual or employer, the court will review the case to determine if the claim was improperly denied. If it was, it will usually reverse the denial and mandate that benefits be paid. At Seelig Law Offices, our attorneys regularly bring these types of lawsuit and achieve favorable results for clients.
If your short-term or long-term disability insurance claim has been denied, the disability attorneys at Seelig Law Offices can help.