Frank N. Darras provides the answers which are key to empowerment when dealing with the complicated language of insurance.
A. Generally, if you have an individual policy purchased through an agent or broker, or if your policy was provided to you by a government employer directly (that is, not through a union or employee organization), then you do not need to appeal. You may file a lawsuit after your first denial.
Read more... A. If you obtained your insurance coverage from your employer, union, or employee organization, a claim against your insurance company is most likely subject to a federal law called the Employee Retirement Income Security Act of 1974, more commonly known by the acronym of “ERISA.”
Read more... A. If your policy falls under the ERISA statute, you cannot sue for punitive damages or bad faith. At best, you can obtain the benefits owed to you in the first place, plus interest. In certain situations, courts may also award attorney fees.
A. Not necessarily. You should immediately consult an attorney experienced in handling LTD cases to determine whether the ERISA deadlines apply to you.
A. Generally, LTD policies will pay either: (a) a set amount of benefits per month, or (b) a percentage of your pre-disability earnings on a monthly basis—often between 50% to 80% of your earnings.
Read more...
A. An “own occupation” provision means that your policy will provide benefits in the event that you are no longer able to perform the material and substantial duties of your own occupation at the onset of your claim.
Read more...
A. The insurance company evaluates your eligibility for benefits based on the definition of “disabled” under your policy. In most LTD policies, “disabled” is defined as having an illness or an injury that prevents you from performing the material and substantial duties of your regular occupation on a full-time basis with reasonable continuity.
Read more...
|
|
