Life insurance claim denials are among the most painful cases that BenGlassLaw handles. People come to us after they have lost a loved one, and they are dealing with additional stress because the insurance company has unexpectedly denied their claim. You need to appeal, but the details of that can be daunting even in the best of times. We can help.
Our goal is to ensure you get the benefits you are entitled to without unnecessary delay. Though some life insurance appeals can take months (or even years), we have experience in this unique area of law and have designed a system to develop the strongest possible appeal and streamline the appeal process as much as we can.
If your claim was denied, contact BenGlassLaw as soon as possible. Often you only have 60 days to appeal these decisions. If you don’t appeal within the insurance company’s timeframe, you lose your opportunity to go to court later. The initial denial will be final. That’s how the law is written.
Here's how BenGlassLaw can help you right now:
- Call (703) 584-7277 and you can speak with one of our knowledgeable insurance appeals specialists.
- If your claim has been denied, fax/email/mail us the denial letter as soon as you get it. We will review it and give you a detailed strategy for moving forward. This service is free, but you must act promptly. The insurance company only gives you a limited time to appeal or their decision is permanent.
- We will evaluate your claim and let you know whether you need to hire an attorney, or whether you might be able to do this yourself.
You can speak with our team of experts about your insurance claim by calling our office at (703) 584-7277.
Why Are Most Life Insurance Claims Denied?
Insurance companies make money by collecting premiums and denying claims. In our experience, many life insurance companies deny claims hoping the claimant won’t pursue it further. This is especially true in life insurance denials, when grieving families just aren’t up to dealing with “one more thing.” And this is a big one!
Most Group Life Insurance policies provided by employers fall under ERISA (the Employee Retirement Income Security Act). Very few attorneys are experienced in ERISA cases, and inexperienced attorneys, while well-meaning, can do more harm than good if they don’t understand ERISA’s specific requirements and potential pitfalls.
ERISA claims and appeals are significantly more complicated than non-ERISA policies. ERISA is a federal law, and the rules FAVOR the insurance companies. ERISA puts claimants at a significant disadvantage if they don’t hire an attorney – even judges have said so.
If your claim meets the criteria in the life insurance policy, you should not be denied your benefits. Some denials are simply the result of errors in the claim (typos, unclear diagnosis, confusion about the scope of coverage, etc.), and the insurance company just has no incentive to try to correct their mistakes or seek more information.
Life insurance claims can be high value, and often the insurance company can mitigate their damages by holding onto your money as long as possible so they can invest YOUR money and earn dividends that way. Even when they KNOW they’re going to lose in the end, they still “win” by delaying the payout as long as possible. And, they figure, there’s always the chance that you will give up and go away. We make sure that doesn’t happen!
What You Can Expect When You Call BenGlassLaw About Your Life Insurance Claim
The first time you call BenGlassLaw, we will ask you some questions about your claim and ask you to send us a copy of the insurance company’s denial letter. Ben and his team of insurance appeals experts will pore over that information and prepare a written report for you. There’s no charge for that.
Our written report will explain why we think the insurance company denied your claim and where we see room for an appeal. If we don’t think you have grounds for an appeal we’ll tell you, and at least you will have the peace of mind of having asked the question.
Denial letters can be securely sent to us via fax (703-783-0686), or you may deliver you letter in person or email a copy to [email protected] Your denial letter is a critical part of our case evaluation, so it is important that we receive it before we can evaluate your case.
In most cases, we CAN appeal the insurance company’s denial. Hiring us is the first step to getting the life insurance benefits you are entitled to. We understand how uniquely stressful life insurance denials are and we can take at least this one big thing off your plate. Our review of your denial letter is at no charge, so please reach out to us today.
If you have already had a claim denied, call our team of experts at (703) 584-7277.
What Does it Mean if ERISA Governs My Insurance Policy?
ERISA stands for “The Employee Retirement Income Security Act of 1974.” That act covers many employee benefits, one of which is private, employer-sponsored life insurance policies.
In general, ERISA is considered a law that largely favors insurers. This is the process with an ERISA covered claim:
- You get very detailed correspondence from the insurance company (or you should) explaining all the reasons why your claim has been denied. These letter almost seem designed to be hard to comprehend.
- You normally get 60 days to appeal the decision (for this reason alone, you must consult with an attorney who understands ERISA life insurance cases), though read your letter carefully to make sure of the timeline.
- The insurer normally gets 45 days to review the appeal, with an optional additional 45-day extension for “good cause shown.” (In reality, the “good cause” is really just “we’ve been super busy this month and didn’t get around to you yet”…and there’s nothing you can do about it).
- If you lose your appeal, you can file suit in federal district court where a judge (and the judge alone, never a jury) will determine your case
- Your case is evaluated through briefs from both sides and a box of records from the insurer. You can’t add any evidence at this stage – you are limited to what was submitted during the appeal.
- The judge is not deciding whether you are right. The judge is only deciding “was the insurer’s decision reasonable in light of all the information it had before it at the time?” Even if the judge would have come to a different conclusion looking at the same evidence, if the insurance company’s interpretation and decision was “reasonable,” you lose.
- An experienced ERISA attorney can make all the difference in these cases. Please contact us and let us see how we can help you.