Nearly all of the employer-sponsored disability insurance plans fall under ERISA. This law gives you the right to file a lawsuit in federal court if your Virginia disability claim is denied, but guess what? The insurance company still has the upper hand.
Courts have given insurance companies a special “ACE” card that they can use, which is known as “reservation of discretion.” This special card basically makes it harder for you to prove your side. For example, you will not win your lawsuit against the insurance company if there is any evidence that supports the insurer’s decision. In other types of legal cases, you only have to have more than 50 percent of the evidence in your favor (known as preponderance of evidence). Based on ERISA, you have to have 85 percent of the evidence, leaving the insurer with only 15 percent. What does that mean for you, as the claimant? It means you lose your case.
For more information about ERISA disability claims and your rights, order a copy of my book, Robbery Without a Gun: Why Your Employer's Long-Term Disability Plan May be a Scam.