How High Level Decisions Impact Your Disability Claim

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How High Level Decisions Impact Your Disability
Claim
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We are hearing from numerous high level
executives with companies whose long term
insurance disability policies, through no fault
of their own, have recently changed from first
class to steerage. The reason? Their employer
changed disability insurance policy providers and
the policy owners have become legacy
policies. Multi-national companies who buy long
term disability insurance policies are great
customers for LTD companies. They are courted by
sales people intent on closing deals on big
contracts, earning the company and the sales
people significant profits. The large regular
premiums mean the LTD company has to keep their
clients happy, taking care not to aggravate too
many claimants. They still deny and delay, but
theres a certain courtesy extended when you are
part of a billion dollar coverage plan.
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But when the love affair is over and the large
company moves its LTD policies to another
carrier, the people who have the policies from
the prior carrier face increasing challenges. The
LTD companies have the potential exposure and
costs of the old policies, but the premiums are
not coming in. From what were seeing, this
decision starts at the top and moves down to the
claims process. High level executives who are on
claim are now more likely to have their benefits
reviewed more intensely, as the managers seek a
reason to deny claims. We believe this also
extends to outside, third party claims offices,
including the doctors and nurses who perform
medical examinations and reviews.
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Many of the calls coming in are from executives
with UNUM and UNUM Provident. They were on claim,
receiving monthly benefits, when out of the blue,
their claims were terminated, or they began
receiving requests for additional information or
reviews of new medical records. Hartford claims
are also common, with formerly Aetna policies in
the crosshairs. Same with Lincoln Financial
claims, on prior Liberty Mutual claims, as these
are all legacy coverage from prior carriers. We
have gone up against all of these companies and
know the ferocity with which claims are being
handled for people whose employer no longer has a
contract with this company is extreme, even for
LTD companies. If your policy is from a company
that your employer no longer uses for LTD
insurance, your claim should be considered
vulnerable.
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If your claim gets terminated, you need to know
how to defend yourself. The insurer is required
to provide you with a written explanation for the
reason for the denial. If you company no longer
does business with the insurer, be mindful they
are going to be aggressive. ERISA requires you
to file an appeal but remember the appeal is
being reviewed by the same company that denied
your claim and ERISA is a complicated law. If
your claim is valued at 500,000 over the life of
the claim, you need to consider retaining an
experienced, knowledgeable LTD attorney. There is
simply too much at stake to try to do this on
your own. If your ERISA appeal is denied, your
only recourse is to go to federal court. Here
again, you need an experienced ERISA attorney to
represent you. Insurers have demonstrated an
increasing willingness to go to court with denied
appeals, so dont be surprised when your D-I-Y
ERISA appeal is denied.
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Anyone whose LTD claim has been denied or
terminated needs to consider how much is at
stake. We routinely find people calling the
office do not realize just how much the value of
their claim holds. Often, the duration is
extensive and the benefits significant. If you
own several policies, which most high-income
earners do, and your payment is in the 10,000 to
15,000 range, your losses could easily reach
120,000 a year. Is it worth it to retain an
attorney to defend your claim? We believe it is
worth at least exploring. Read more here - How
High Level Decisions Impact Your Disability Claim
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Newfield Law Group

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• 555 Broadhollow Road, Suite 403, Melville NY
  11747
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• jason_at_newfieldlawgroup.com
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