Someone that has sustained a serious injury, as the result of an accident might wonder why an insurance company has chosen to deny requested long-term disability coverage. Sometimes, the confused victim feels compelled to seek an appeal. Lawyers urge their clients to weigh all the influences, before going after an appeal.
Elements lacking prior to the launching of an appeal:
The denial letter seldom gives the reason for the insurance company’s decision. That fact highlights the difficulty of fighting the denial. Until a lawyer can discover why a client’s request has been denied, it makes no sense to try reversing the insurance company’s decision.
The insurer has not provided the denied policy holder with a paper stating the opinion of the insurer’s doctor. In the absence of that opinion, it becomes almost impossible to frame a good argument, one that seems capable of swaying the opinion of a judge in the appeal’s court. Sometimes the policy holder has lost the copy of his or her policy. In that case, it makes no sense to move forward, until another copy of the insurance policy can be obtained.
Things known before launching any appeal:
Personal Injury Lawyer in Fredericton know the system used in insurance companies. The people that review requests for long term disability coverage also review any request for an appeal. It does not make much sense to seek permission for appealing a decision from the same men and women that voted in favor of the disappointing denial.
Lawyers know how long it can take for the appeals process to get completed. Submission of a request does not mean that the appeal’s start could be just around the corner. It could take as long as one year for the insurance company to respond to the policy holder’s request.
Can an attorney suggest an alternative approach?
An attorney understands the expectations that the legal system has of an insurance company. It is supposed to work to meet the needs of its policy holders. An insurance company must have a good reason for denying a policy holder of coverage, when that same policy holder has been paying for such coverage.
An insurance company must provide the court with evidence to support a denial of long term disability coverage. A lawyer’s experience allows that professional to anticipate the nature of such evidence. By anticipating that evidence, a lawyer can prepare a counter-argument.
Insurers do not like to be sued for bad faith. Yet an insurer invites such an action, if a policy holder has been denied long term disability benefits for no apparent reason. A lawyer can use that fact, when working to develop an alternative approach, one that should be more successful than appealing would be.