Miami Attorney J.P. Gonzalez-Sirgo Represents Disability Insurance Policy Holders in Claims against Insurance Companies.
You may have obtained your policy through your employer. Most Group Long-Term Disability (LTD) policies are provided to employees by the employer who may pay all or some portion of the premium. The employer is considered to be the “policyholder” and the employee is the “certificate holder.” Each employee receives a “certificate booklet” describing the terms of their policy. Group polices are regulated or governed by the Employment Retirement Income Security Act (ERISA) of 1974. There are some group policies that are not governed by ERISA, but not many. These types of polices are not individually underwritten and the risk is spread out among all members of the insured employer group.
Or you may have purchased your policy on your own. These are individual disability policies, purchased from an agent or directly from the insurer, which are individually underwritten by the disability insurance company. Like with most types of insurance policies, the disability insurance company assumes all of the risk of any future claims. These policies are not governed by ERISA.
The Claim: Just Because An Insurance Company Says It Doesn’t Make It Fact
After struggling to fill out your claim forms and collect information proving your disability, your insurance company informs you that your claim has been denied or that you will not be receiving the full amount of financial support that you are owed. Suddenly, you have yet another stressful problem to contend with: you aren’t well enough to work, and your one safeguard has fallen through.
Disability insurance cases are unique in that they tend to be more complex than other types of insurance coverage cases. This is due in part because, in many instances, federal law (ERISA) applies to your claim. Disability insurance contracts can be intricate and difficult to understand. Even filing your initial claim can be a highly involved and convoluted process that could lead to your request being denied for a number of reasons.
You can be bombarded with unfamiliar terms: effective dates of coverage, elimination period, activities of daily living, minimum hours requirements, pre-existing conditions, recurrent provisions, non-integrated policies, self-reported symptoms, waiting periods, etc.
Don’t be intimidated. It is not uncommon for an insurance company to deny a disability insurance claim because, based on their “review”, they have determined that you are not “disabled”. This decision is often based on the opinion of an insurance company employee with some “medical training” that has reviewed your medical chart. Or it’s based on the opinion of some vendor or medical doctor that provides pro-insurance company opinions that are biased by their desire to continue a profitable relationship with the insurer. Just because an insurance company says it doesn’t make it fact. Don’t let the insurance company intimidate you into compromising your claim
Not Fighting For Your Disability Payments Could Alter Your Life Forever
If you think that you can get by without receiving your disability benefits or with the small sum that your insurance company has offered you, consider these sobering statistics from the Council for Disability Awareness:
You bought disability insurance in order to prevent these consequences. Don’t let insurance fraud by your disability carrier steer you down the path of financial and personal ruin.
Level the Playing Field With Your Insurance Company
The sooner that you get effective counsel on your side the easier it will be to navigate your claim.
I understand that many of our clients do not have the resources or means to pay lawyer fees out of pocket. Because of this, I offer free consultations. In the great majority of cases, if I decide to go forward with your case, I will work on a contingency fee basis, which means that you do not pay attorney’s fees unless there is a recovery on your claim.
There are numerous challenges facing policy holders attempting to have their insurance claims timely honored by insurance companies: The delays in investigation of claims, the endless request for documents, requests for sworn statements or examinations under oath, requests for recorded statements, requests for independent or compulsory medical evaluations, fraud accusations, application issues, material misrepresentation issues, supplemental claim issues, bad faith insurance claims, including litigation. Insurance claims attorney J.P. Gonzalez-Sirgo can prosecute your insurance claim.
Insurance claims attorney J.P. Gonzalez-Sirgo, P.A. helps insurance policy holders recover what they are due on their insurance claims. If you or a loved one has suffered from disability insurance fraud or bad faith, contact me today. For a free consultation, please contact our office in Miami Dade County at 305-461-1095 or toll free at 1-866-71-CLAIM or fill out the short online contact form and a member of our office will contact you immediately or visit us in Espanol.
We welcome attorney referrals from our colleagues. Many of our clients come to us as a result of referrals from other attorneys who know of our success in handling first party insurance claims. We encourage and welcome these co-counsel opportunities and routinely share fees in accordance with the rules regulating the Florida Bar and Florida law. We recognize the trust placed in us by our referring attorneys and so we make sure that our referring attorneys are kept in the loop throughout our representation, from the initial intake through the conclusion of the case.
J.P. Gonzalez-Sirgo, P.A. provides experienced insurance law, coverage and bad faith insurance claims legal counsel and representation for businesses and individuals throughout Florida and Miami Dade County, including Aventura, Bal Harbour, Carol City, Coral Gables, Doral, Florida City, Golden Beach, Hialeah, Hialeah Gardens, Homestead, Kendall, Key Biscayne, Medley, Miami, Miami Beach, Miami Lakes, Miami Gardens, Miami Shores, Miami Springs, North Bay, North Miami, Opa Locka, Pinecrest, South Miami, Sunny Isles Beach, Surfside, Sweetwater, Virginia Gardens, West Miami, Westchester, all the Florida Keys communities, including Broward and Palm Beach Counties.
J.P. Gonzalez-Sirgo, P.A.
Douglas Entrance
804 Douglas Road
Suite 373
Coral Gables, FL 33134
Phone: (305) 461-1095
Fax: (305) 461-1096
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