People often ask us what the chances are that they will win a lawsuit in a long-term disability claim, but it is impossible to answer with certainty because of the number of factors that go into the decision. However, we can speak from our firm’s own experience:
First, we must clarify what we mean by “winning a lawsuit.” Oftentimes, when a case goes to court, most long-term disability claims are settled in mediation. This means the claimant is not necessarily put on claim, but instead, they accept a lump sum payment and go their separate ways from the insurance company. If you define that as the win, the vast majority of claims that go to court end up settling for a lump sum payment, which we would classify as “winning the lawsuit.”
When a case does not settle in mediation, the parties typically file cross-motions for summary judgment, where the parties let the court decide which side wins, and it becomes an “all or nothing” situation. Either the claimant wins benefits, and their benefits are reinstated, or the insurance company wins, and the claimant receives nothing.
Now, let’s talk about cases more generally and more nationally. When you look at decisions that are issued by the court on cross-motions for summary judgment, you’ll see that the insurance company wins those cases that do not settle about anywhere from 80-85% of the time. I don’t think it’s because we have bad lawyers on our side of the fence (the plaintiffs’ side). In fact, I believe we have a lot of good lawyers fighting on the plaintiff’s side.
Insurance carriers win the majority of claims that go to motions for summary judgment because the law heavily favors the insurance companies. This is why it is so hard to “win” a long-term disability claim in court.
When you turn that around, the insurance companies understand that they might have a 15 or 20% chance of losing. To determine the “settlement value” of a claim, the insurance company multiplies that 15 or 20% risk factor against the total value of the claim, which means that insurance companies typically want to settle disability insurance claims for about 15 or 20% of the total value of the case.
Our goal in representing claimants is the exact opposite of the insurance companies’ goal. We want to obtain the largest settlement possible for our clients. It is possible to settle LTD cases that have gone to court for 20-50% of the total present value of the claim. Some may settle for an even larger percentage than in that range if the medical and opinion evidence well supports the case and the insurance company’s decision is without any reasonable basis.
Every case is unique, so I encourage you to give us a call to discuss your case. Although based in Florida, the Ortiz Law Firm represents claimants across the United States. If your LTD claim has been wrongfully denied, delayed, or terminated, and you’d like to speak to an experienced long-term disability insurance attorney, call us at (888) 321-8131 to schedule a consultation. We can help you evaluate your claim to recover the benefits you deserve.