There are steps that may be required to appeal a long term disability insurance claim denial depending on whether the policy is governed by the Employee Retirement Income Security Act of 1976 (ERISA).
Most individually purchased (non-group) long term disability insurance polices are not governed by ERISA. Similarly, long term disabilty insurance policies issued as part of a public sector (government) employee benefit plan are also not governed by ERISA. If your policy does not fall under ERISA, you may be able to file a lawsuit without being required to exhaust your administrative remedies such as the appeals required under ERISA. Individually purchased long term disability insurance policies, those not covered by ERISA, are governed by the statutory and common law of the state in which the policy was issued.
On the other hand, if your policy falls under ERISA, you will be required to follow all of the appeal procedures required by your employer's plan. A lawsuit cannot proceed under an insurance policy governed by ERISA unless all of the administrative remedies have been exhausted.
If you have been denied long term disability insurance benefits, your insurer should explain the basis for the denial in writing and any required appeals process. An experienced long term disability insurance claims lawyer should be consulted.
You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].
