The pitfalls of doing your own appeal without talking to an attorney first.

Why pass on free personalized advice?

One of the people who contacted us this week was a woman who had her Long Term Disability benefits terminated by Standard Insurance Company after Standard had paid her those benefits for many years. Despite multiple surgeries, her symptoms had not improved. Each morning she takes powerful pain medications. Sometimes those medications offer enough relief to enable her to attend to daily functions, but often, they do not.

Either way, she was certainly not able to perform the duties of her job when Standard cut off her benefits. Nonetheless, Standard Insurance Company all of the sudden determined she had not provided sufficient proof of disability and terminated her Long Term Disability benefits. Thinking this was simply a misunderstanding, she appealed the denial on her own without speaking to an attorney first. After all she reasoned, Standard Insurance Company had told her all she needed to do was explain to them why she was still disabled.

This woman’s appeal consisted of an email explaining her condition and a request that Standard Insurance Company speak with her doctor. (An experienced attorney would have advised her that was never going to be enough — and it was not.)  Standard Insurance Company upheld the denial of benefits on appeal.

After the final denial on appeal, this woman’s only option was to file a lawsuit against Standard Insurance Company. However, due to the “ERISA rules” governing her claim, she was now likely at a disadvantage because the evidence a Court would consider had not been fully developed during the appeal.

Had she first consulted with an attorney with experience in this area, perhaps she could have avoided a lawsuit altogether. It seems like every week we have to tell a person whose life was disrupted by the denial of their insurance benefits that the biggest problem with their case is that they did not know the “rules” for appealing the denial of benefits. Regardless of whether your insurance company is Aetna, or Anthem, or Cigna, or LINA, or MetLife, or Prudential, or Unum, or any other company, it pays to know the “rules.”

So before you start to appeal the denial of your insurance benefits, call a knowledgeable attorney. It usually won’t even cost you any money for the consultation!

Kantor & Kantor’s lawyers provide free consultations. FREE. We mean it when we say, “We are more than willing to review your documents and discuss your matter at no charge, so long as your issues are related to our areas of practice.” We have extensive experience in how to get Long Term Disability and Life insurance denials overturned. We also have extensive experience in how to win Long Term Disability and Life insurance denials in Court. Call us. We’re here to help. (877) 783-8686.

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