Disability Insurance Claims Denials

Reno, NV Disability Attorney
Disability insurance is designed to give people peace of mind in the event that they become disabled and unable to work. It is not uncommon, however, for disability insurance claim disputes to arise regarding coverage, eligibility, and amount of benefits.

If your disability insurance claim has been denied, you may be able to appeal the decision. Appealing a disability insurance claim denial can be a difficult and time-consuming process, however, so you should consult with a disability attorney as soon as possible.

For more than 15 years, disability insurance claims attorney Matthew L. Sharp has been helping clients get the maximum disability benefits. He will represent you in connection with your disability claim and, if necessary, he help you appeal an insurance claim denial.

Contact disability attorney Matthew Sharp at (775) 324-1500 to learn more about your legal rights and options.

Types of Disability Coverage
There are generally two types of disability insurance coverage:

  • Coverage for the policyholder’s own occupation: Also known as an “own occupation” policy, this policy provides the policyholder with benefits in the event that he or she cannot perform the material and substantial duties of his or her existing job.
  • Coverage for any occupation: This policy provides benefits in the event that the policyholder cannot perform the duties for any job for which he or she is reasonably suited based upon his or her education and training.

Some policies may have a combination of both own occupation and any occupation coverage. For example, the policy may provide benefits for the policyholder’s own occupation for a specific time period and thereafter coverage is provided only if the policyholder is disabled from any occupation.

Not only are there different types of disability coverage, but there are also different types of insurance policies. An individual policy is purchased by the policyholder, whereas a group disability insurance policy is generally purchased by the policyholder’s employer as part of its employee benefits package.

Disability Insurance Benefits
The legal rights and options vary depending on whether the policy is an individual or group policy. Under an individual insurance policy and certain types of group disability insurance policies, the insurance company must:

  • Promptly pay all valid claims
  • Investigate and evaluate all claims before denying or refuse to pay a claim
  • Provide a valid reason for a claim denial, including a factual and legal justification for the claim denial.

If an insurance company denies a disability claim without a valid legal or factual justification, or without conducting a claim investigation and evaluation, the policyholder may have a claim for insurance bad faith.

Group insurance policies are governed by the federal Employee Retirement Income Securities Act (ERISA). Under ERISA laws, disability insurance claims denials can be difficult, time-consuming, and complex. For this reason, it is highly recommended that you consult with an insurance disability lawyer as soon as possible for help with the appeals process.

Contact a Lawyer for Your Disability Claim
If you or a loved one has become disabled, you may be entitled to disability benefits through an individual or group insurance policy. Moreover, you may also be entitled to Social Security disability benefits. Obtaining these disability benefits can be an overwhelming process, however, making the help of a disability attorney important and beneficial to the swift and favorable resolution of your claim.

Contact disability insurance claim attorney Matthew Sharp at (775) 324-1500 for help pursuing or appealing a disability insurance claim.

For Additional Information