When you’ve been injured or are ill and unable to work, disability insurance is your lifeblood. When an insurance company attempts to deny or take your benefits away, that can be devastating to you and your family.
We handle disability, ERISA, and bad faith cases in federal and state courts throughout Florida and Georgia.
Insurance companies commonly deny legitimate claims after manipulating the facts, conducting surveillance and/or requiring you to undergo an independent medical evaluation (IME) or functional capacity evaluation (FCE), which they may or may not have the right to do or which they may do in a manner inconsistent with the policy terms or the law. Insurance carriers dedicate an enormous amount of time, money and resources to the processing of a claim in order to attempt to legitimize its denial of benefits.
Your individual disability insurance policy is regulated by state law. If your claim is denied, you must exhaust any required appeals of the carrier’s denial of benefits, then you have the right to file a lawsuit under state law in state or federal court and have a jury trial. The common claims against the insurance carrier are breach of contract and bad faith. A breach of contract claim is brought against the insurance carrier when it fails or refuses to pay or settle a claim in violation of the terms of the policy.
Typically, a group policy provided by your employer is governed by The Employee Retirement Income Security Act of 1974 (“ERISA”). ERISA is a federal law that provides standards for how a claim is administered, including deadlines on employees and insurance carriers for the filing, responding and appealing of a claim for benefits. ERISA was enacted to protect workers but, in practice, it favors employers and carriers who know how to manipulate the facts, the claims process and the laws.
Damages are typically limited to the payment of any back benefits, reinstatement of benefits and interest on the back benefits and possibly the recovery of a reasonable attorney’s fee. A bad faith claim under Florida law is filed when the carrier acts fraudulently or wrongfully denies or fails to settle a legitimate claim. A claim for bad faith may entitle you to punitive damages and recovery of a reasonable attorney’s fee and cost of litigation in addition to your monthly benefits. It is important that you understand the terms of your policy and the law and that you defend your rights by consulting with an experienced disability insurance attorney. |