Many people are dismayed when long term disability insurers essentially invent ways to deny legitimate claims. But unfortunately, initial denials are part of the twisted games that insurers play in order to convince their customers to give up on claims. While treating vulnerable consumers horribly would doom most businesses, it actually works to an insurer’s benefit. Why? Because the sum of all “ifs” work towards an insurer’s benefit.
Basically, claimants must overcome a gauntlet of uncertainties in order to receive benefits after a denial. Insurers bank on the notion that one of them will work out in their favor. Once that happens, the insurer wins. For those not familiar with those “ifs”, this post will highlight them.
If the claim is appealable – Because of the intricacy and short timelines that insurers allow for appeals, insurers anticipate that a majority of consumers will not pursue an appeal. A percentage of those who do appeal will be limited because of preventable mistakes.
If a lawyer will take the case – Insurers also believe that an attorney will shy away from taking on such a case because of the work involved and the complex laws surrounding ERISA claims.
If the court rules in favor of the claimant – Again, insurers bank on the notion that a case will not even get to trial, and that it could be dismissed on procedural grounds.
Despite the number of “ifs” involved, the reality is that denied claims can be successfully appealed, a skilled disability rights lawyer can take your case, strong arguments can be raised to obtain a ruling in your favor. Because of the sheer number of successful denials, insurers are not likely to change their practices anytime soon. As such, an experienced attorney can turn the sum of all “ifs” into a win.