My Disability Benefits Claim Was Denied. Now What?

It’s no secret that many insurance companies have negative reputations, and many are well-deserved. From misleading claimants with elaborate verbiage to abruptly terminating disability benefits without cause, it isn’t uncommon for insurers to take advantage of their beneficiaries.

That’s where a qualified disability insurance attorney can help. What steps can beneficiaries take after a disability insurer denies or terminates the benefits they need and deserve? Keep reading to learn more about the process of appealing denied or terminated disability benefits in Florida.

Types of Disability Insurance in Florida

There are various types of disability benefits in Florida, including:

Short-Term Disability Benefits

Short-term disability (STD) benefits are designed to provide financial assistance for individuals who are temporarily unable to work due to an illness, injury, or medical condition. The coverage period for short-term disability benefits typically ranges from a few months to one year. Claims for short-term disability benefits typically have a shorter waiting period before benefits kick in, which can range from a couple of days to two weeks after the onset of disability.

In terms of amount, the benefits received are typically a percentage of your regular income. Generally, beneficiaries will receive anywhere from 60% to 70% of their income. However, it's imperative to understand that policies vary from person to person, making it especially crucial for disabled Floridians to have a comprehensive understanding of their specific plan.

Long-Term Disability Benefits

Long-term disability (LTD) benefits cater to those who have more serious, long-lasting health conditions that prevent them from working for an extended period. The coverage period for LTD can last several years or potentially until retirement age, depending on the policy.

Like short-term disability benefits, LTD benefits replace a portion of your regular income, but the percentage can differ based on your specific policy. The waiting period before you can start receiving LTD benefits is typically longer than STD, often requiring several months.

Common Disability Insurance Lawsuits

When it comes to securing and maintaining disability benefits, the process can be complex and time-consuming. For many disabled people in Florida, even extensive evidence isn’t enough to “prove” the lifelong hardships and pain they must endure on a daily basis, often leading to frustration and dead ends.

Sadly, many of these beneficiaries cannot afford to waste more time and energy arguing with disability insurers who violate their legal and ethical obligations under ERISA law. Fortunately, a qualified disability attorney can help clients navigate a range of disability insurance lawsuits, including:

Filing a claim for disability benefits.

The process of filing a claim for disability benefits can be daunting. It involves gathering extensive medical evidence, filling out detailed forms, and often dealing with insurance company bureaucracy. The most common lawsuit in this stage arises when the insurer denies the claim, alleging that the claimant is not disabled or that the medical evidence is insufficient. In such cases, a lawsuit can be filed to challenge the denial and seek a court order awarding the benefits.

Appealing the denial of disability benefits.

If your disability insurance claim is denied, you have the right to appeal the decision. This process usually involves submitting additional medical evidence and written arguments detailing why the denial was incorrect. Lawsuits at this stage typically occur when an insurer upholds their denial after an appeal. The lawsuit seeks to overturn the insurer's decision and secure the benefits originally claimed.

Appealing the wrongful termination of disability benefits.

Sometimes, an insurer may terminate disability benefits prematurely, alleging that the claimant is no longer disabled or that they no longer meet the policy's definition of disability. This can result in a lawsuit to challenge the termination. These lawsuits aim to reinstate the terminated benefits and ensure that the claimant continues to receive the support they need.

How to Appeal the Denial or Termination of Disability Benefits

What should beneficiaries do after their insurer denies or terminates their disability benefits? Below are these 4 key steps to take after a wrongful termination or rejection:

  1. Consult with a qualified disability insurance attorney – When facing denied or wrongfully terminated disability benefits, securing sound counsel from a knowledgeable disability attorney is a nonnegotiable first step. Given that your financial security and health are at stake, it's important to collaborate with a trusted legal representative who can guide you through the complexities of the legal proceedings and safeguard your best interests against insurers who may try to take advantage.
  2. Understand the reason for denial – Your insurer is required to provide a valid reason for denying your claim. Understanding this reason is the first step toward formulating an effective appeal. An experienced disability lawyer will have an in-depth understanding of disability insurer behavior to pinpoint the issue and hold the insurance company accountable for their actions.
  3. Fortify your case with relevant evidence – If your insurer denied your claim due to insufficient medical evidence, your attorney can help you gather all relevant evidence to fortify your case, such as additional records, physician statements, and any other relevant documentation that substantiates your disability.
  4. File an appeal – Most disability insurance policies allow for an appeal process. Make sure to adhere to the deadlines and procedures outlined in your policy. Your lawyer can work closely with you to examine all aspects of your plan and hold your insurer accountable for their legal and ethical obligations.

Remember, a disability claim denial is not the end of the road. With persistence, the right information, and dependable representation, it's possible to overturn a denial. Hiring a trusted attorney with a comprehensive understanding of disability insurance laws in Florida can help you navigate the myriad of complex regulations and procedures involved in filing or appealing a claim, as they can fight to ensure that you are treated fairly under the law.

Passionate Advocacy for the Disabled in Fort Lauderdale

Our Fort Lauderdale disability attorney has over 45 years of experience representing beneficiaries in a variety of disability insurance cases, from LTD coverage to ERISA claims. If you were unfairly wronged by a disability insurer, it’s imperative to turn to a legal advocate with experience navigating denied claims by popular big-name insurers, such as Hartford, Unum, MetLife, Mutual of Omaha, Reliance Standard, and more.

Since 1972, Attorney Martin J. Sperry has advocated on behalf of disabled Floridians in their time of need, successfully fighting to secure the benefits they need to live the quality of life they deserve. Don’t wait to take legal action against an unethical employer. Reach out to our firm to secure experienced representation for your disability insurance claim or appeal.

Did your insurer deny or wrongfully terminate your disability benefits? Turn to a trusted Florida disability attorney. Call (954) 324-2340 to request a consultation.