You cannot file a lawsuit for denied disability insurance benefits until you have exhausted your administrative appeal rights. This means you have to go through the appeal process with your insurance company before you can take legal action.
Under ERISA, when a claim is denied or benefits terminated, the claimant is afforded an opportunity to appeal the denial or termination of benefits. This is not optional, though. It is required under ERISA before any legal action can be taken.
The appeal is an opportunity for the claimant to have their claim reviewed again by the insurance company. ERISA requires the appeal review be conducted by people who never handled your claim before. In other words, it is supposed to be reviewed with a “fresh set of eyes.”
Typically, you have 180 days from the date of the letter advising you your claim has been denied or terminated, to submit a written appeal. The insurance company has 45 days plus one 45-day extension for special circumstances to approve or deny your claim.
If the appeal has been denied, your file closes. It is at that point you can take legal action on the denied claim. There are rare exceptions to filing a lawsuit prior to the appeal being decided, but in general, you must go through the appeal process before you can take legal action.
It is important to know that some insurance companies require two appeals. Your policy will outline the appeal procedures, including whether you have one or two required appeals. If you fail to submit the required appeals on time, you may be barred from pursuing the claim further in court.
Lawyers Specializing in Disability Insurance Claims
Because disability insurance law is complicated, it is important to get legal help from a lawyer who focuses on disability law.
As a law firm built to focus on disability insurance, our lawyers specialize in disability insurance. We spend every day working to get our clients long term disability benefits approved.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
If your claim for long term disability benefits was denied or being delayed by an insurance company, call us to speak with a disability insurance attorney.
We represent clients across the U.S. with:
- Experience with every major disability insurance company.
- A proven track record of success in major disability lawsuits.
- Recovered millions of dollars in disability benefits for our clients.
And, we never charge fees or costs unless our clients get paid.
Call us at (800) 969-0488 or contact us online to speak with an experienced disability attorney. Consultations are free.