If you have sustained an injury or suffer from a medical condition that prevents you from working on a permanent basis, you know just how hard it is to support yourself and your loved ones. Individuals who take their long term disability claims to our law firm are understandably at one of the lowest points in their lives. They are forced to fight with their insurance companies over what they were promised and what they paid for. If your disability claim gets denied, it can feel like your whole world has shut down.
This experience is destructive to not only the individual, but to his or her family members and loved ones as well. Every Milwaukee, WI disability lawyer at Urban & Taylor, S.C. understands this fact. We know how important your disability claim is to you. It’s our priority that you are treated fairly, with dignity, and with compassion and understanding. You should not be treated with disrespect or disdain by an insurance company simply because you had the misfortune to become disabled.
Types of Long Term Disability Claims
Before we can help you settle your long term disability claim, we must understand the type of claim you have. There is more than one type of disability insurance offered in the state of Wisconsin. These are the different types of long term claims our firm is ready to assist you and your family with:
Long Term Group (ERISA) Disability Claim
Long term group disability insurance is offered in accordance with your employer’s group benefit package. Most workplaces offer this type of insurance automatically. Group policies provided to you by your employer are governed by the Employee Retirement Income Security Act of 1974 (commonly referred to as “ERISA”), a federal law that provides standards for how a claim can be administered.
ERISA guidelines include deadlines imposed on employees and insurance carriers for the filing, responding, and appealing of a claim for benefits. While ERISA was enacted to protect workers, in practice it favors employers and carriers who know how to manipulate the facts, the claims process, and the laws. The unfortunate fact is that most employers set up group insurance to save them as much money as possible.
What this means is that insurance companies can devote an enormous amount of time and resources to building a case for the denial of your claim for benefits. This can involve several known tactics that include conducting video surveillance to capture you exceeding the limitations set by your physicians or demanding an “independent” medical evaluation (IME) or functional capacity evaluation (FCE).
These evaluations, performed by “professionals” that depend on these same insurance companies for their income, are rarely independent, and almost always support the insurance company’s case for denial. These evaluations are conducted as cheaply as possible and may be conducted in another state or city or by someone other than a medical professional. In some cases, the insurance carrier may not even have a right to conduct an evaluation at all.
At first glance, the filing of an ERISA insurance claim may appear to be an easy task, but most disability claim forms are designed to ask vague questions which then allow the carrier to draw unsupported conclusions and delay your claim under the guise that more information is needed. Delays, most of the time, ultimately lead to claim denials.
As anyone who’s successfully received disability insurance will tell you, most claims are repeatedly denied without the help of the disability lawyer. Under ERISA’s laws, you have 180 days to appeal a denial of benefits which begins to run as of the date you receive the denial letter. It is extremely important that you know your responsibilities as well as the carrier’s obligations.
You have an obligation to appeal the denial in a timely manner. If you fail to do so, you may lose your rights forever. Know and defend your rights by seeking a Wisconsin disability lawyer with experience in dealing with ERISA laws and the insurance carriers that tend to make claims difficult.
Long Term Individual Disability Claim
If you do not have group disability insurance that’s offered through your employer, Wisconsin law will regulate your long term individual disability insurance policy. If your original claim required appeals of the carrier’s denial of benefits, you have the right to file a lawsuit and request a jury trial.
The most common lawsuits against insurance companies include breach of contract and bad faith claims. A breach of contract claim is brought against an insurance company when it fails or refuses to pay or settle a claim in violation of the terms of the policy. Damages are typically limited to retroactive payment of any back benefits, reinstatement of benefits, and interest on the past benefits.
A bad faith claim under Wisconsin law is filed when the carrier acts fraudulently, wrongfully denies or fails to settle a legitimate claim, or fails to pay a claim when there is no reasonable debatable basis to do so. A claim for bad faith may entitle you to punitive damages, recovery of a reasonable attorney’s fee, and the cost of litigation in addition to your monthly benefits.
Getting the Help You Need from a Milwaukee Disability Lawyer
Regardless of the type of long term disability claim you need help settling, we can help. At the law firm of Urban & Taylor, S.C., we will do everything in our power to level the playing field and ensure you recover the benefits you deserve. Don’t wait and allow the insurance company to take advantage of your situation.
Contact Urban & Taylor, S.C. immediately if you believe you may have a long term disability claim, wish to appeal a claim denial, or feel your insurance company is denying you benefits. We can pair you with a skilled and knowledgeable Milwaukee, WI disability lawyer who can stand up and fight for you.
