If you have had disability benefits reinstated after a denial in ERISA-based disability benefits claim, either through a successful appeal or through the court system, there is nothing stopping the insurance company from once again denying your Long Term Disability claim. In fact, in the Eleventh Circuit, which includes Alabama, Florida and Georgia, your insurance company is financially incentivized to deny claims again and again.
This is because in the Eleventh Circuit, you cannot sue for the interest on benefits wrongfully denied alone and must go through the appeal process first. The insurer can make interest on this withheld money, indeed, at a much higher rate than a layperson would generate.
State laws protect against this kind of unethical behavior, however, the federal law of ERISA shields these insurance companies from lawsuits such as bad faith claims and disability insurers can continue to deny valid claims with impunity.
Furthermore, disability insurers can deny your Long Term Disability claim more than once. Even if you have had your wrongfully denied benefits reinstated, and you feel like you overcame Mount Everest in doing so, there is nothing stopping them from denying your claim once again in the future. You are required to give the insurer updates pertaining to your medical condition and they are able to use whatever reasoning they can come up with to deny your claim once again.
The only way to truly get the insurance company out of your life for good is to accept an offer of a lump sum payment. This is calculated by bringing the amount of benefits owed in the future to present value. There are many factors to consider before settling a claim this way, but having the insurance company out of your life is a benefit that cannot be understated.
At Herbert M. Hill, P.A., once you hire us as your attorneys in your Short or Long Term Disability claim, we are your attorneys for the duration of your entitlement to benefits, regardless of whether your claim is currently be paid or has been denied, because we know that the battle is not over until the disability insurer is out of your life for good.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.