And How and When Not to…
If you should become disabled under a private insurance policy obtaining benefits is not always as easy as simply submitting your claim. There are important pitfalls you need to avoid in order to prevent your claim from being denied or underpaid.
Knowing “when” to seek legal counsel is one of the first questions we receive from insurance policyholders who have become disabled under private insurance policies.
Generally, the earlier in the process you obtain advice on a long-term disability insurance claim, the better. This is a complex area – both because of the wording of the policies, and because of the laws and regulations affecting them.
Keeping this in mind when you begin medical treatment is essential. It is important that you be diagnosed and treated by highly-skilled, credible medical experts who are familiar with the legal meaning of the terminology contained in the physician statement forms, which they will be required to complete.
Once you begin the claim process, all documentation will be placed under scrutiny. The claims forms you must submit to your company can present a mine field of potentially hazardous obstacles, and improper documentation can cause long-term delays or even denial of benefits.
If you speak to an experienced Long Term Disability Insurance lawyer BEFORE you file your claim, you can avoid making critical mistakes during the process. (Your discussions with the lawyer will be confidential and privileged.)
Choosing the right lawyer to represent you in an LTDI claim can be a daunting task.
Here are five important questions you should ask any lawyer you are considering retaining:
1. Does the lawyer specialize in handling only individual Long Term Disability Insurance claims?
It is virtually impossible to maintain any real expertise in more than one area of the law. Even within the disability field there are big differences between a workers compensation claim, a Social Security Claim, a state disability claim and an individual Long Term Disability claim. Those important differences include the definitions of disability, the definition of your occupation, the definition of the occupational duties you must be unable to perform, the difference between Total versus Residual disability and many other matters.
Many insurers will search for reasons to deny or minimize your claim. You should limit your selection process to lawyers who handle only Long Term Disability claims. Experienced specialists in this field will know the policies, the players, and the process. Don’t go to your best friend’s divorce lawyer with a LTDI claim. (And don’t go to an LTDI lawyer to represent you in a divorce.) Even firms that advertise Disability Insurance Claims assistance aren’t always experienced in Private Long-Term Disability Claims, which can greatly affect the outcome of your case.
2. Has the lawyer advertised for clients?
If the answer is yes, run for the hills. Avoid advertising lawyers like the plague. Period. Top-notch Long-Term Disability Lawyers do not need to advertise. Beyond that, most, if not all, of the attorneys whose grins you see on CNN or FOX TV misrepresent, or flat-out lie, about their experience. Often, they don’t even handle disability cases. They simply collect them and sell them for fat “referral” fees. Steer clear.
3. How many Long Term Disability cases has the lawyer actually tried to a jury verdict and . . .won?
How many Verdicts has he/she obtained? In what amounts? Have the verdicts been upheld on appeal?
When you ask these questions many lawyers will change the subject. Why? Because if the answer is “none” you should look elsewhere. You want to get a fast, fair, settlement, not drag on for years and to go to trial. To get a good settlement you absolutely have to have a credible attorney – with a proven track record of trying and winning LTDI cases. Such credibility is based on three things above all else. Past Performance. Past Performance and Past Performance.
You may think that all lawyers promoting themselves as experts in this field have tried and won big verdicts, but, believe it or not, some of the biggest “names” in the disability claims business talk the talk but have never walked the walk. Many have never tried and won a single disability jury case.
In addition, be careful to avoid lawyers that churn multiple cases by under-settling them. It’s one thing to settle a large claim for $650,000, and then move on to the next case. It’s something else to settle the same case for $1.2 million.
4. For what percentage of the present value of the future policy benefits did the lawyer settle his/her most recent cases?
When you multiply a claimant’s monthly Total Disability benefit by the remaining life of the policy (minus the Discount Rate if there’s no COLA) what percentage of this number did the lawyer’s recent cases settle for? 60%? 80%? 100%? 120%?
If the lawyer tells you he/she can’t reveal this because it is “confidential information” join the guy in #2 (above) and beat a hasty retreat. This is NOT confidential information. The only facts that are (sometimes) confidential are the dollar amounts of settlements, coupled with clients’ names and the names of the settling insurers. The percentage of the present value of past settlements is not confidential. A lawyer should have no objection to providing you with the answer to this question.
5. How long did it take the lawyer to settle his/her last ten disability cases?
In general, cases should settle within about two to five months from the day the day of inception. There are legitimate exceptions but if resolutions have consistently been taking longer, find out why.
There are, of course, other questions you might want to ask in certain situations, such as:
- Is the lawyer in good standing with the local Bar Association?
- Have they written any articles or given seminars on issues related to disability insurance claim issues?
Bear in mind that lawyers can be pretty good at avoiding answering a straight question with a straight answer. Try to make sure you actually wind up getting the information you need to make an informed choice. The amount of your recovery will depend on it.