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Long-Term and Short-Term Disability Insurance Claim Denials

Long-Term Disability Insurance Attorneys

Leverty & Associates Law Chtd. has experience with long-term and short-term disability insurance claim denials. One buys short-term and long-term disability insurance to financially assist them and their family in the event they cannot work to earn a salary. Long-term disability insurance coverage is generally provided in three (3) different ways: (1) You are considered disabled because you cannot perform your own occupation; (2) You are considered disabled only if you cannot perform any occupation; and (3) a combination of being disabled from performing your own occupation for a set number of years (usually two (2) years) and then you must be disabled from performing any occupation.

Own vs. Any Occupation

An own occupation policy provides benefits where you cannot perform the material and substantial duties of your job.

An any occupation policy provides benefits where you cannot perform the duties for any job for which you are reasonably suited based upon your education and training.

Long Term Disability Insurance Is Provided Either as (1) an Individual Policy or (2) as A Group Policy.

Individual insurance is generally insurance you buy on your own. However, if you purchase your disability on your own but by or through your employer it still may be governed by ERISA and limit your legal rights and benefits.

Group insurance is insurance you generally buy through your employer or insurance that is paid for by your employer as part of your employee benefits. It is import to know whether you have a group insurance policy or purchased the disability insurance through your employer because it can be governed by ERISA and dramatically limit your legal rights and benefits.

Your Rights If You Have Individual Disability Insurance Policy or You Obtained Your Disability Policy by or Through a State, County or City or Church Employer.

Generally, if you have an individual disability insurance policy or you obtained your group disability insurance policy by or through any governmental entity (state, county, city) except the federal government then you have certain rights when dealing with your insurance company:

  • Your disability insurance company must promptly pay your claim –

  • Your disability insurance company cannot deny or refuse to pay your claim unless it first investigates and evaluates your claim.

  • When investigating and evaluating your claim, your disability insurance company must look for reasons pay the claim.

  • If it denies your claim, your disability insurance company must give you the factual and legal basis for denying the claim.

Employee Retirement Income Securities Act (ERISA)

If you have a group long-term disability insurance policy purchased through or provided to you by your employer and you are not employed by a state or local government, you still have the right to expect your disability insurance company to treat you fairly and in good faith. However, generally if you obtained your disability insurance through your employer, it is most likely that your remedies will be governed by a ERISA.

If your disability insurer denied your claim or terminated your benefits, it is important you immediately seek an attorney to assist you so that you do everything correctly to protect your appeal and legal rights. Contact your Reno Nevada Disability Insurance Attorneys, Leverty & Associates Law Chtd. at (775) 322-6636 for a Free Consultation. Our goal is to help you understand your rights when dealing with your disability insurance company. Leverty & Associates Law Chtd. has helped persons whose disability claim has either been improperly denied or improperly terminated. See Hertz v. Hartford Life & Accident Ins. Co., 991 F. Supp. 2d 1121 (D. Nev. 2014).

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