Handling Disability Insurance Claims in Colorado
One form of protection against financial disaster is long-term disability insurance. If the insurance is provided in connection with employment, claims are governed by federal legislation known as ERISA. Originally conceived in the mid-1970s to prevent irregularities in the investment of pension and benefit funds, ERISA has become a serious impediment to fair treatment of disabled persons who depend on private insurance to replace their income. Early involvement of a lawyer is crucial.
Jim Cederberg is an experienced attorney who will help you collect the compensation you deserve from a long-term disability insurance policy. To learn more about your long-term disability and ERISA claim, contact the Cederberg Law Firm in Boulder, Colorado, for a free consultation.
Helping You Navigate the Long-Term Disability and ERISA Claims Process
ERISA and the cases interpreting it have created a somewhat complex and difficult-to-navigate system of procedures and requirements that is unlike non-ERISA claims. Key features are:
- The plan administrator (often the insurance company itself) is given broad latitude in making the decision to award or deny benefits. A court will only reverse a denial of benefits if there has been an abuse of discretion, also called arbitrary and capricious conduct.
- The claimant must exhaust administrative review by the plan administrator before he or she can turn to the courts for relief. This may seem innocuous, but see step 3.
- If suit is filed, the record that the court can consider is limited to whatever was in the claim file at the time of the administrative review. Therefore, it is extremely important to obtain a lawyer at the administrative appeal stage (as soon as an initial denial letter and notice of right to appeal are received) so that the lawyer can make sure the record is complete and obtain additional evidence to support your claim and add to the record.
- Court review is by a judge with no jury. Since the judge is limited to the administrative record, there typically isn’t even a trial. The judge reviews the written record and arguments of counsel and makes a decision.
- Common law remedies for bad faith are not available. Recovery is limited to the benefits owed.
- About the only favorable thing about ERISA cases is that you can recover attorney's fees.
ERISA also applies to employment-related health insurance claims and pension benefits.
Occasionally, individuals purchase their own disability insurance outside of their employment. In these cases, the same rules apply that govern other kinds of insurance claims.
In 2007, Jim Cederberg won a 10-year battle with the country’s largest and most aggressive disability insurance company. After two appeals to the 10th Circuit, his client was paid more than $2.3 million in benefits, interest and attorney's fees.
Contact the Cederberg Law Firm to schedule a free consultation to learn more about your long-term disability and ERISA claim.
