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If you have received a disability denial letter from your insurance company, you may be feeling stressed out and unsure of what to do next. The good news is that you are not alone. In the current climate, insurance companies deny many valid disability claims. Just because your claim was denied does not mean that you are out of options. You must keep fighting for what is rightfully yours. Our experienced Oakland ERISA disability lawyers can help. We will review your claim for free, and in the process, we will explain your rights to you and help you assess your legal options so that you can make an informed decision on what to do next.
The Employee Retirement Income Security Act of 1974 (ERISA) establishes strict process-based regulations for disability claims that are filed under group welfare benefits plans. For example, one such regulation requires all insurance companies to respond to a claim with an approval or refusal within 45 days. The insurer may request two 30-day extension periods if it is needed to make a decision on the case. Then, in the event that the insurer refuses to pay benefits, they must send a written denial letter that clearly articulates the exact reasoning why they made that decision.
At that point, the applicant will have 180 days to file an internal appeal to seek his or her disability benefits. If you are filing an ERISA disability appeal, then it is imperative that you do so with the guidance of an experienced Oakland ERISA disability attorney. Your attorney will be able to help you correct any problems with your initial filing. This is critically important, as your appeal should directly address the reasoning that the insurance company used to deny your claim.
Under ERISA regulations, you can only file a lawsuit to seek your disability benefits after you have gone through the entirety of the insurance company’s internal appeals process. During this process, you should submit additional evidence into your claim file. The insurance company will not tell you this, but if you fail to submit evidence at this time, you will lose out on access to that evidence. Indeed, with very few exceptions, courts are only allowed to look at your official claim file when ruling on your lawsuit. Evidence that does not make it into the claim file, with very limited exceptions, will be left out of your court case. To ensure that your claims rights are properly protected, you should get an experienced Oakland ERISA disability attorney by your side as soon as you receive your initial denial letter.
We can help. At Kantor & Kantor LLP, our legal team proudly advocates for individuals who have had their ERISA disability claim wrongfully refused by the insurance company. If your claim was denied in Oakland, please contact us today.
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