by Cody AllisonHas UNUM Denied Your Long Term Disability Claim?
Many people are just not familiar with what to do if your benefit has been denied. Below is some explanation of what to do if your carrier is UNUM and they deny your benefit. They have to follow certain procedures to deny this benefit, and you should check and make sure these procedures have been followed. If you need help, please call us. We are ready to help!
Formerly know as UnumProvident, UNUM is one on the largest providers of long term disability (LTD) insurance in the United States. They are based in Chattanooga, TN and trade on the New York Stock Exchange under the ticker symbol UNM. They are a Fortune 500 Company, have over 9000 employees, and reported revenues topping 10 billion in 2013.
How does the claimant stand a chance against such a large corporation? Answer: Exercise your rights under the law.
If denied, UNUM, or any ERISA based long term disability plan, is required to notify you in writing through a denial letter. Further, they MUST give you a reason for the denial. Some reasons given for denial of your benefits include: lack of medical documentation, lack of detail about your disability, or failure to meet certain LTD policy definitions.
If denied benefits after your initial application, should you accept the insurance company’s denial as the end of the road? NO!
You have rights which include appeals and the possibility of a lawsuit; but be sure to act quickly, your rights are time sensitive. Most importantly, don’t give up. That’s what the big insurance companies want you to do.
At Cody Allison & Associates, PLLC we fight denied long term disability claims everyday. It’s what we do. If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000. We are based in Nashville, TN; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonSixth Circuit Decision Affirms 3,800,000.00 “Disgorgement Award”
We are asked if the insurance company can be “punished” for failure to pay off a rightful claim. Below is an example of that happening. One of the things that a court must consider in these cases is the fact that, if an insurance company doesn’t pay a substantial claim for a long period of time, that company is getting the benefit of holding on to the claimant’s money, including using it operating capital and earning interest from it. Here, there is a disgorgement award ordered — the insurance company not only has to pay out the money that it wrongfully denied a claimant, but it has to pay out profits it received from holding on to that money. In effect, the court is punishing the company for its wrongful act.
If you feel that you have a claim that is being wrongfully denied, contact us right way. We are here to help!
In an ERISA long-term disability (LTD) case, disgorgement refers to the Court ordering the insurance company to pay, not only the claimant’s benefits under their policy, but also profits the insurance company made while denying the claim (and holding onto the money).
On December 6, 2013, the Sixth Circuit Court of Appeals decision in Rochow v. Life Insurance Company of North America (LINA) sent a message that, not only did the Court have the authority to make such an award, but it would use that authority to right what it perceived as a wrong. The basis of the large monetary calculation was ROE, or return on equity. The Court used this method to determine the level of unjust enrichment to the LTD insurance company and then returned the determined amount to the claimant. The Court also appeared to be sending a message to the LTD insurance industry to act in good faith when evaluating a claim, or the Court might make a disgorgement award.
Many ERISA and non-ERISA long term disability claims are wrongfully denied each year. Wrongful denials enable the big insurance companies to hold your money while they seek to make profits the longer they hold your money. If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000. We are based in Nashville, TN; however, we represent clients in many states. We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonLong Term Disability Benefits Wrongfully Denied — Cigna to Pay Over $77 Million
Sometimes, people feel like they are having to fight against a faceless corporation that really doesn’t have their best interests at heart, just to recover benefits that they are entitled to under an insurance policy that they have paid years of premiums to have. These corporations have excessive amounts of money and attorneys at their disposal and can continue to deny claims for years. This is why is it is so important to get someone on your side to fight these folks. In this case, the Court found that Cigna had spent years wrongfully denying claims, and ordered them to go back through these denied claims and re-evaluate them, which could result in Cigna paying many millions of dollars to claimants.
Here at Cody Allison and Associates, we stand ready to assist you. If you feel that your claim has been wrongfully denied, call us. We can help.
Cigna Insurance Company is one of the top five largest group disability insurance companies in the Country. Following a very lengthy investigation which began in September, 2009 and was concluded on May 13, 2013 by the Department of Insurance Investigators from the States of California, Maine, Connecticut, Pennsylvania and Massachusetts. The investigation regarding the long-term disability claims handling practices of Cigna Insurance resulted with the signing of a Regulatory Settlement Agreement (“Cigna Agreement”) on May 13, 2013. The Agreement which Cigna Insurance has entered into requires Cigna Insurance Company to re-evaluate thousands of long term disability claims that were previously denied which could result in Cigna paying out $77 Million for potential claims that were wrongfully denied.
At Cody Allison & Associates, we handle ERISA long-term disability claims and are based in Nashville, Tennessee, however we handle claims all throughout the state of Tennessee as well as other states. If you have a long-term disability claim that has previously been denied by Cigna Group Insurance, please call Cody Allison & Associates at (615) 234-6000 for a free case analysis. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonI’m Getting Paid Under “Reservation of Rights” — What does this mean?
When you review your policy prior to filing a claim, you are probably going to run into terms in the policy that you don’t understand. One of the terms that we get asked about most is the “reservation of rights” clause in a policy, although this is not the only “legalspeak” term you are going to run across. Below is an explanation of what this term means. This illustrates the point that it is important to get a competent professional to review your policy and give you advice about your rights under the policy, and also to explain the meanings of these terms. At Cody Allison and Associates, we stand ready to help you.
If you are receiving long-term disability benefits and have been told it’s under “Reservation of Rights”, this means that while the insurance company is still reviewing your claim to approve benefits or deny benefits, they will pay you under Reservation of Rights. After the insurance company reviews your claim and makes a decision, they will either start paying your claim normally and no longer under Reservation of Rights or they can deny your claim and you will receive no more benefits.
If you are getting paid under Reservation of Rights, please call Cody Allison & Associates at (615) 234-6000 and we will be happy to go over your claim with you free of charge. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonWill my long-term disability claim be denied if I do not have surgery?
Occasionally, we get clients or callers who are worried because their Dr. has recommended surgery and they just don’t want to have surgery. This can be for various reasons. They are worried that if they don’t follow the course of treatment recommended by the Dr. by not having the surgery, their coverage will be denied. Below is the answer to the question of what happens if an insured chooses not to have surgery. Remember, here at Cody Allison and Associates, we are available to help you and answer any question you may have. If you have questions or concerns about your disability claim, give us a call today.
Our office gets asked this question often. My doctor has recommended surgery and indicates that other than surgery, there is nothing more he can do for me. Will my long-term disability claim be denied if I do not have surgery?
The disability carrier cannot force you to undergo surgery. For example, if you have back problems and have seen an orthopedic and a neurosurgeon, and the neurosurgeon is recommending surgery, and you do not want to undergo surgery for several reasons, the carrier cannot deny your claim for not going through with the surgery that your neurosurgeon has recommended. You can continue to treat with other conservative treatments.
If you have any other concerns or questions regarding this matter, please call Cody Allison & Associates at (615) 234-6000 and we will be happy to answer any other questions you may have. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.
by Cody AllisonIf your doctor has not released you to go back to work, your disability claim can still be denied.
There are certain rules that every claimant must know when making a disability claim under a policy. These rules are usually outlined in your policy. It is important to know them and abide by them to not give the insurer an excuse to deny the claim. However, there are some things that you may not really have any control over. In this instance, a disability claim may be denied even though your treating physician has not released you to return to work. Below is an explanation of how this can be done. If you need help with your case or feel that your claim has been wrongfully denied, please contact us to discuss the matter.
If your doctor has not released you to go back to work, your long-term disability claim may still be and can be denied. After the insurance company receives your claim, they will review your medical records and will start their own investigation of your claim. In this process, the insurance company may send your medical records to their own independent doctors to do a peer review. If any of these doctors conclude they don’t find any restrictions or limitations that prevent this individual from working, the insurance company can and most likely will deny the claim. They can deny your claim based on their independent peer review doctor’s opinion, regardless of what the treating physician or physicians who treat you regularly state.
If your treating physician states that you cannot work, or hasn’t released you to go back to work yet, and you received a denial from your long-term disability carrier, please call Cody Allison & Associates at (615) 234-6000 and we will provide you with a free case analysis.
by Cody AllisonHow do I obtain a copy of my long-term disability policy?
This is probably one of the most common questions we are asked. Your disability policy is absolutely necessary to have because it contains the full agreement between you and your plan provider. It will tell when things need to be filed, and define terms that are going to become very important in your case. As soon as possible, you need to request a copy of this policy. Any attorney you contact will need a copy of this policy up front in order to be able to know what must be done in your case so you can recover under your policy. Below is concise information about how to get a copy of this policy. Remember, if you have questions or need help, Cody Allison and Associates stands ready to assist you. Call us today!
If your long-term disability policy is an ERISA plan, through your employer, than you need to request a copy of the policy to the plan administrator. This is usually the employer in most cases. The request needs to be in writing and send the request certified return receipt mail via United States Postal Service. Failure by an administrator to provide you with a copy of your long-term disability policy within 30 days of your written request could subject the administrator to a civil penalty of $110.00 per day. However, the administrator would only be subject to this penalty if a federal lawsuit is filed and the Judge agrees to fine the administrator.
There are many details and definitions in your long-term disability policy, so you want to make sure you receive a copy of the policy and not just a summary plan description of your policy.
If you have received your long-term disability policy and need help understanding what you may be entitled to, please call Cody Allison & Associates at (615) 234-6000, and we will review your policy free of charge.
by Cody AllisonFibromyalgia and Long-Term Disability
The link below carries you to a NOLO article regarding the intersection of fibromyalgia and LTD claims. The article makes the very important point that many insurance companies almost automatically deny claims related to this debilitating disease and that it may be necessary to bring in an experienced attorney to handle a long-term disability claim based on fibromyalgia. Here at Cody Allison and Associates, we have experience with these kinds of claims and we stand ready to help you recover the benefits that are due to you. Contact us today!
http://www.nolo.com/legal-encyclopedia/long-term-disability-benefits-fibromyalgia.html