Insurance companies don't make money if every insured knows their rights. Many insurance companies will deny benefits automatically, hoping that you won't question their decision. So many times, we have spoken to clients who are unsure if they can even appeal the decision. They are confused, because their disability is clear, and the doctor agrees they are unable to work.
The plaintiff, as beneficiary of a plan, is entitled to bring a civil action to recover disability benefits if those benefits are due to him under the terms of the plan. 29 U.S.C. § 1132(a)(1)(B). This means that you are allowed to file a lawsuit if you have been denied benefits, but are entitled to them based on your plan and condition. This is important for you to understand. Whatever your insurance company says, even if they have denied you benefits and say you are fit to work, you need to explore your options with an experienced long term disability attorney.
Not many attorneys work on long term disability cases. Often, people confuse this practice area with social security disability. ERISA long term disability applies to employer provided, or personally purchased long term disability plans. The insurance companies are private companies, and they are motivated by their company's profit. Their goal is to pay out as few benefits as possible. If you don't hire an attorney, you may lose out on benefits that you are entitled to.
Many long term disability plans and policies have a limit on the number of appeals you can file against them. Be sure not to waste your appeals. If your insurance company is fighting you, contact BenGlassLaw at (703) 584-7277.