CAN I FIGHT MY INSURANCE COMPANY'S DENIAL OF DISABILITY BENEFITS IN PENNSYLVANIA AND ELSEWHERE? YOU CAN AND YOU SHOULD
In my experience, many long-term disability carriers deny long-term disability benefit claims even where it is clear such benefits should be granted. Why? It has long been understood that companies allow or foster dangerous or unfair situations to occur because the cost to do otherwise would be too significant. Think exploding Ford Pintos, Vioxx, Ford Bronco rollovers, Norplant. Here is the commonly understood test that companies employ when deciding whether a given business practice is worth the risk: X our of 10 people will be harmed or killed. Y out of X people harmed or killed will sue us. The cost to defend each suit will be Z. We will win W% of the lawsuits and pay approximately $V per. VERSUS: How much money will we make if keep doing nothing and keep selling the product? How much money will it cost us to pull the product or change our practice plus how much will we lose if we stop selling the product or change our practice? IF The cost to recall and stop selling the product greatly exceeds to cost of defending lawsuits and paying judgments, then let's keep doing what we are doing. Shocked? You shouldn't be - corporations have no soul and exist only to make money. So, how does this figure into your Long-Term Disability denial? Simple, insurance companies know that many people who are denied will think they cannot win, or cannot afford an attorney. Of those who do fight, they figure, they will win a certain percentage of the cases. They will use in house lawyers to keep the cost down and, Voila!, the denial letter goes out. Simple!
ARE THERE CONTINGENCY FEE DISABILITY LAWYERS IN PENNSYLVANIA AND ELSEWHERE?
But, you can afford an attorney, and should fight. Any experienced disability lawyer handles these cases on a contingent fee basis - which means you don't have to pay your lawyer unless you win. And, you should get an attorney. It is crucial to understand that, if you lose your claim with the agency, and exhaust all of your appeal rights, then you can go to federal court under a statute known as ERISA to win your benefits. However, the federal court will only consider the "record" you made during the appeal process before the insurer in deciding whether the denial was appropriate. In other words, you cannot submit new medical evidence to the federal court if you could have previously submitted it to the insurer during your appeal from its denial of benefits but failed to do so. Long-Term Disability benefits are absolutely crucial to those in need of them. Your insurance company may not care, if it thinks it can get away with denying your claim. Don't let them get away with it.