A Cautionary Tale: a very successful business owner developed a progressive condition that forced him to sell his highly lucrative professional practice and make a disability claim. Before filing his claim he consulted with his financial advisor who felt, for some reason, that he should join his wife's business as a partner. The financial advisor failed to even ask for, let alone read, the business owner's long-term disability insurance policy. That policy attributed one-half of his wife's business profits to the claimant, even though he did nothing in the business. His wife's business was also highly successful. As a result, his long-term disability claim was properly denied because he could not demonstrate loss of income.
This was an unforced error caused by the fact that the claimant did not understand the long-term disability policy he bought and, for years, paid the premiums for.
Here's the Deal:
You built it but now an illness or injury is preventing you from working in the business you love to your full capacity. Your life, and your financial life, in particular, is complicated. Most disability insurance policies were written with the hourly worker in mind and that's probably not you.
You should talk to a law firm that understands your complex life and which has substantial experience advising, working with, and representing highly successful people like you who are insured under either a group or private long-term disability policy.
An attorney who understands you and your life can advise you about the nitty-gritty of your policy, review the detailed application process, help you determine where your claim needs support, and in some cases, work with your doctors and employers to ensure your claim gets paid.
Three Things A Business Owner Should Ask a Long Term Disability Attorney AFTER Receiving a Claim Denial
- What Happened? (An experienced attorney’s office should be able to answer this for you in some detail based only on your denial letter. We do that for free.)
- What’s Next? (You are always entitled to at least one appeal of your claim after a denial.)
- Will You Handle My Case All the Way Through to a Lawsuit If Necessary? The only acceptable answer to this is Yes. Here’s why: the same insurance company that just incorrectly decided your claim may also incorrectly decide your appeal. It happens, no matter how strong your appeal is, especially if you are a high-wage earner. An experienced disability attorney understands this and is preparing your appeal with an eye on your litigation case.
Why does this matter? Because the law says that in general, no new information can be added to your claim after your appeal is denied. If there is evidence you want the judge to consider, you must add it to your appeal. If there are things the insurance company missed in evaluating your claim, you have to present your evidence in the appeal. There’s no such thing as saving your best arguments for the judge in these cases. Your appeal is your one and only chance to add everything a judge might later need to decide your case. DON’T WASTE IT!
How We Will Help
- If you have a letter from an insurance company, we’ll review it for free and let you know what we think. There’s no obligation. If you decide that’s all you need, we’ll be here if you need us again in the future.
- If you have a question or want to discuss your claim, we offer a flat-fee initial consultation (currently $600). At a minimum, we will need to review a copy of your disability policy before getting on a call or video chat to discuss your case. If appropriate, we will also review any recent medical records you send us. If you hire us at any point to do additional work on your claim, we will credit the appeal fee to the fee for future work. Often, this is all our clients need to resolve their cases.
A Second Cautionary Tale: Don't Let This Happen to You
In another case, a business owner had a condition that required him to drastically reduce, but not eliminate the time he could devote to the business. His friends told him that he made too much money to file a disability claim.
His friends were wrong. This owner should have filed a claim for partial or residual disability benefits.
Not only did he leave hundreds of thousands of dollars on the table, money his family desperately needed, but when it came time to claim total disability under his policy, his benefits were based on his vastly reduced income, not his top-earning years just before he developed his condition. He was forced to sell his house to make up for the reduced long-term disability payments.
Had he come to us as soon as he had a significant reduction in income, we could have helped him maximize his benefits and keep him and his family in their home.