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Don't think you are out of options!

Don't think that you have no options just because you have a denied claim. They deny claims all the time but when you get an attorney involved it often turns around rather quickly, in some cases. Their job is to try to convince you that you don't have a claim but using poor excuses. When this happens you need to find a qualified Florida private disability insurance attorney that can take your case and get you the results you are entitled to.

The first step you need to take it to check to see if your insurance was ERISA-governed.

The ERISA, Employee retirement income security act, is federally regulated that applies to some companies, non-profits, and public or religious organizations. It is there to protect the employees by state law. While you work personal injury lawyer for a company that carries private insurance, more often than not, that insurance was backed by and governed the ERISA.

Challenge disability denial

While the ERISA has ways that you can make a claim to appeal what the insurance has set forth, there are steps that you need to take. They set a number of unique limitations onto the way that a person can challenge denial. As well as they set the way that the denials will be litigated in federal court.

Since 1974 ERISA was set up to help assist the system from getting overwhelmed with false claims on either side. This system is to be just for both sides. While the system has expanded over time to cover a number of things, it is there to keep systems in place to ensure that both sides are being treated fairly.

First they must go through administrative exhaustion, meaning that they need to try to come to an agreement within their insurance company's systems before going further to court. At this stage, you should have an attorney present to represent you, as you know they certainly will. You can do this two times before it is considered exhausted.

Timing is everything!

While every plan is a bit different, most are governed by the ERISA. A third party will then be brought in to look at the case and see if they can come to a reasonable and acceptable decision. This is all done on a timeline, which means that you need to know this timeline or you might lose out. This particular part of the process must be done within 6 months of receiving the denial letter. If you fail to do so, that is telling them that you accept their denial and aren't going to further persist.

While you have six months, they only have 45 days to accept your denial and go over the information again. During this time, they can ask for up to two extensions, if the case is complex, they will most likely take the extensions.

If they look over everything again, they can then accept your claim with the new information, or they can deny the claim. They are also known to talk down the claim, so say you are looking for compensation for life, they might only offer a temporary solution. At this point, you can bring on a lawsuit against the insurance company.

Illinois uses the Novo review standard and bans discretionary clauses.

While the discretionary clause will go over what was actually done in the case up to this point, this has no relevance in Illinois court. This is the court where everything is wiped clean and they will go down their own path of exploring what happened and who is entitled to what. This is where it is important that you fully understand the law and what it entails.

If your claim is in Illinois then you will not have to deal with discretionary clauses.

If your claim is in the state of Illinois, or the company is, this clause is for you as well. What caused this decision by the insurance company in the first place is irrelevant at this time. They want everything to be gone over again as if there wasn't a decision in the first place.

Retaliation is prohibited

Retaliation is prohibited in the state of Illinois. This means that you cannot be tormented by your employer by not getting raises, promotions, and car accident lawyers other things once you can return to work due to an injury. You are protected by the ERISA and can sue your employer for further damages, should they retaliate.

While most insurance is backed by the ERISA, some are not. Those people do not have to go through an internal process that can be rather drawn out. Now, you don't have the protection of the ERISA but there are benefits to this as well. If you are in a financial crisis and need the benefits to cover your cost of living, then this route would probably help. Some people simply cannot wait for the long-drawn-out process of going through ERISA.

While the internal process may seem to be a waste of time, in fact, it really can be beneficial. Especially if you were a person that didn't have the proper attorney the first time. We can go over things and ensure they have the proper documentation that they need to make the decision you want. This will allow them to have all of the evidence that they need to review.