After an injured employee has received short-term disability benefits for 2 years, he or she has the right to apply for long-term disability benefits (LTD). Still, the insurance company offers no guarantee that the policyholder’s financial assistance should continue. It could be denied.
Steps to be taken by a policyholder that has been denied LTD benefits
Review the letter in which the denial was stated. Ask for and review the insurance policy, and any related documents. Contact your doctor, your insurance company and any hospital that has administered tests or treatment. Use the information obtained to build a case.Contact a Personal Injury Lawyer in St John’s, one that specializes in cases such as yours.
Tasks performed by lawyer
Collect copies of your medical records. You will need to obtain letters from your doctors, letters that can confirm any claims regarding the prescribed treatment for your injuries, and your readiness to follow that treatment. Only after that request an appeal hearing
Understand that an appeal does not guarantee the eventual payment of LTD benefits.
The insurance company could issue a second denial. A smart policyholder allows for that possibility. He or she acts in a manner that would allow the filing of a lawsuit against the insurance company. Insurance companies can be sued for non-payment of any policyholder.
It is best to file a lawsuit while pursuing the appeal. There could be a very small window of time in which to file a lawsuit. The limitation period given to policyholders by the statutes governing an insurance company’s actions does not change when some policyholder has chosen to pursue an appeal. That means that the clock continues to click, even as the appeal continues. In other words, a policyholder invites a risky and unwanted situation by refusing to sue an insurance company until after the result of the appeal is known.
Other guidance that can help policyholders that are fighting the denial of LTD benefits
Be sure to save all correspondence. Take notes, when speaking by phone with a member of the insurance company. Realize that the people working in the human resources department of the company that hired you want to help you. Those people do not want the insurance company to be sued.
If that company were sued, it might increase the price paid for premiums. That higher price would have to be paid by your former employer. Consequently, employees in the Human Resources Department should be ready to work with you. Moreover, if you felt that your former employer’s insurance company had cheated you, you might share details of your case with others. Eventually, as word spread, there could be less people applying for jobs at your former employer’s company.