If you applied for long-term disability benefits and your insurance company denied your claim or if your insurance company terminated or cut-off your benefits, you may be wondering what options are available to you. Generally, an insured person, whether through a group benefits policy or through an individual (private) policy, will either have to appeal the denial or terminate or start a lawsuit against their insurance company. Which option is best will be determined by a number of factors, including time limitations, the reason for the denial and the evidence available to refute the denial. If you are unsure whether you should appeal or commence a legal proceeding, it is best to consult with an experienced long-term disability lawyer for advice.
At MK Disability Lawyers, our senior partners have over 50 years’ combined experience representing clients in long-term disability disputes. We will review your policy and the surrounding circumstances and provide advice on your best path forward. If you choose to appeal your insurer’s decision, we can provide a range of services to assist and set you up for success. Below, we provide an overview of the appeal process and how we can help. For a more detailed guide to appealing a denial or termination of long-term disability benefits, please see our guide here.
How Does an Appeal of a Long-Term Disability Claim Decision Work?
Upon denying or terminating your benefits, your insurance company probably offered you the option to appeal the decision. Most insurance companies will provide a letter setting out a list of documents that you or your doctor would need to submit in order for you to appeal the decision.
Once received, the insurance company will review the new documentation you submitted and decide whether the new information is sufficient to change its decision and reinstate or approve your benefits.
If your appeal is successful, your benefits will be paid from the date the insurance company stopped paying your benefits or from when you were first entitled to benefits, based on the date of your initial claim. You will then continue to receive disability benefits on a monthly basis, so long as you continue to meet the definition of disability and other conditions in the policy.
Do I Need a Lawyer to Appeal my Long-Term Disability Claim?
You may or may not decide you need help from a lawyer with your appeal. If your appeal is complicated or if dealing with the insurance company has become a damaging source of stress and anxiety for you, MK Disability Lawyers can help you. However, you may be able to appeal the decision on your own or with minimal guidance from a disability lawyer. MK Disability Lawyers can provide various levels of assistance with your appeal, depending on your individual needs. Ensuring that individuals receive assistance in dealing with insurers is of the utmost importance to us.
If your long-term disability claim has been denied or terminated for any reason and you are considering appealing the decision on your own or with the assistance of a lawyer, we encourage you to contact MK Disability Lawyers for a free consultation. We will review your case with you, provide you with information and insights about your case and help you decide whether to submit an appeal or to start a court action against the insurance company. We will also help you decide if you need legal help with your appeal, and if so, which type of assistance would be most beneficial.
How Can MK Disability Lawyers Assist with a Long-Term Disability Appeal?
If appealing to the insurance company makes sense for you and for your specific claim, if your claim is complicated, or if continuing to deal with the insurance company on your own is taking a toll on your health, MK Disability Lawyers can help. Knowing what information the insurance company needs and how to present that evidence in a persuasive way, can enhance the chances of a successful appeal, while also allowing you to focus your efforts and energy on your health and recovery.
We can assist in your long-term disability appeal in several ways, including:
- Reviewing your termination/denial letter(s), insurance policy, claims file and medical records to determine the best strategy and approach for appealing the denial or termination of your claim;
- Determining what information is going to give you the best chance of persuading the insurance company to approve your benefits;
- Obtaining (or providing you with guidance for you to obtain) the information you need for your appeal;
- Drafting (or helping you draft) a cover letter for your appeal, detailing the basis for your appeal and summarizing the information that best supports your claim;
- Taking over all (or some) communications with the insurance company on your behalf during the appeal process.
Markham & Toronto Long-Term Disability Lawyers Representing Clients in Appeals from a Denial or Termination of Benefits
If you have been denied benefits or had your benefits terminated and are still unable to work, you may feel alone and unsure of your next steps. At MK Disability Lawyers, we have the skills and the depth of understanding necessary to advise you on how to proceed and can take the stress of managing an appeal off your hands, so you can focus on your health. We bring knowledge from both sides of these disputes that enables us to anticipate the challenges the providers will use to deny or terminate a claim and prepare accordingly. To arrange a complimentary consultation with one of our experienced disability lawyers, please complete the online form, or call us at 844-697-4600.