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Find an Attorney: Bad Faith
Claims
Legal Causes of Action
What is Disability Insurance?
History of Insurance Industry Denial
Sample Cases
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Q: How does Disability Insurance Work?
A: Individual Disability Insurance (DI) is designed to protect
employed individuals from financial disaster in the event of
a disability that prevents a person from working. The odds of
an individual becoming disabled for ninety days or more before
age 65 is one in eight. In contrast, the odds of a house burning
down are nearly one in 1,200. As medicine advances, doctors can
more often prevent death; however, frequently the patient suffers
from a permanent or long-term disability. In addition, a study
of 2000 severely ill patients indicates that although 96 percent
had health insurance, 31 percent lost their life savings. Twenty-nine
percent of the patients lost their major source of income as
a result of their illness. In the United States, 48 percent of
all mortgage foreclosures are caused by the onset of a disability.
Unlike workers compensation, DI supplements an individual's income
even in cases where their sickness or injury did not result from
a job related incident. For this reason, the availability of
DI, and the ability to collect on a DI policy in the case of
a long-term disability are extremely important for the average
worker.
Q: I can no longer work and my insurance company is refusing
to pay me. What can I do?
A: Unfortunately, you may need legal help. A lawyer
can help you protect your policyholder rights and put an end
to delaying tactics. If the insurer denies coverage, you can
attempt to get the court to order short-term payment. Usually
however, it will take over a year to fight for your benefits
while the case is in litigation. The amount you may receive may
include damages for the insurance companies bad faith in denying
your claim.
Q: I am out of work, how can I pay my lawyer?
A: If you have a private disability policy, have been
disabled and the insurer is refusing to pay, our attorneys may
represent you on a contingency basis, where the you would pay
out of the proceeds of any eventual settlement, with the lawyer
receiving a percentage of the recovery from the insurance company.
Q: What types of Cases do you handle?
A: We handle claims by individuals for non-payment and termination
of payment long-term disability (LTD) benefits. We also represent
people in denials of benefits under long-term disability plans,
non-ERISA (private and public employee group plans). We also
handle ERISA claims.
Q: Why do Insurance companies refuse to pay?
A: Economics. In the past twenty years many high-income professionals
were believed to be good risks for disability income insurance.
The industry believed most or many would never makes claims,
but unfortunately, the number of people injured defied the odds.
The number of claims mounted and the insurance companies such
as Unum Provident Group, Paul Revere and Guardian faced losses
on these policies. The industry aggressively looked for ways
out of paying these policies, and in some cases may have crossed
the line, unlawfully denying many professionals owed money under
insurance contracts.
Q: What is ERISA?
A: ERISA is an acronym for the Employee Retirement
Income Security Act of 1974. ERISA was passed by Congress in
1974 to combat corruption in many pension plans. Ironically,
ERISA was not originally designed to control medical or disability
insurance plans, but the phrase in the act "employee welfare
benefit plan," has been subsequently interpreted by federal
courts' to ERISA control over nearly all private employee benefits,
including health, disability, life and pension plans. We do not
handle ERISA claims.
Q: Am covered by a private plan or ERISA?
A: ERISA controls nearly every employer-sponsored benefit
plan, but does not apply to individual policies purchased privately.
If you are a public employee you are also outside of ERISA.
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