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What should you do if your disability insurance is denied? Marc Whitehead is a disability insurance attorney in Texas who handles claims nationwide. He says you should immediately consult a professional to learn about your rights and options.
One of the most common things that happens in our practices is clients will come to us with a denial letter in hand from their disability insurance company, and they paid the premiums on this disability insurance policy for a number of years, either individually or through their employer, and then they have to make a claim because they become disabled either because of injury or illness, and they make the claim with their insurance company, frequently with the help with their employer, and all of a sudden they get this denial letter and like, what do you do? Well the first thing is obviously to consult with somebody that understands that disability insurance and what you'll see is that at the end of that letter hopefully they will explain to you your rights to appeal that denial of their decision, because you do still have rights either under state insurance law or federal ERISA law to appeal that denial. Usually that appeal will tell you you have 180 days to file an appeal and if you exhaust those appellate remedies you have a right to file a lawsuit. Usually either in state or federal court if it's based under federal ERISA law. The key there though is that that administrative appeal is critically important. You've really got to load the record with all of your favorable evidence explaining to both the insurance company at the moment and down the line maybe the judge is going to be looking at your case as to why that initial denial was incorrect and point out the evidence that supports your claim for disability because ultimately these benefits are things that you paid for over the years and they made a promise to you and now you need to work to make them keep their promise. My advice is always to consult with an experienced disability attorney before you do anything because there are many traps that the claimant could fall into if they represent themselves and claim this.
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