Disability insurance is intended to protect employees from the loss of income resulting from an inability to work due to an accident injury or illness. You receive short term disability benefits after a short waiting period (typically referred to as an “elimination period”) of 0, 7, 14, or 30 days, and the benefits are payable for a specific duration (most commonly 3, 6, 12, or 24 months). Long term disability benefits are usually payable at the end of the STD benefit period. Thus, LTD benefits typically start three to six months after you become unable to work.
Unfortunately, disability insurance companies like American Fidelity do not always pay benefits as they should. Claims are often denied or terminated prematurely. That’s where the Ortiz Law Firm can be of legal assistance. The Ortiz Law Firm represents employees and individuals when their disability insurance claims have been wrongfully denied or terminated.
American Fidelity Disability Insurance Denials
American Fidelity’s own website says it offers disability insurance as a way to “Prepare for the Unexpected.” American Fidelity states, “Disability insurance can help protect your future finances in case of a sudden accident or illness by providing a benefit to help cover expenses while you are unable to work. Watch this short video to learn about disability insurance.”Unfortunately, American Fidelity does not always live up to its end of the bargain. We have consulted with a multitude of American Fidelity policyholders whose LTD claims have been wrongfully denied or terminated (cut-off).
American Fidelity Long Term Disability Attorney
As stated above, many individuals who file for long term disability benefits are shocked and dismayed with the hurdles placed in front of them by American Fidelity in filing the claim. American Fidelity requests more and more paperwork as part of the “proof of loss”. Just when you think you’ve filled out the last form, you are given yet another one to fill out. Your doctor may begin to get annoyed with American Fidelity’s phone calls to the doctor’s office and numerous requests for the doctor to also fill out paperwork. Then, after the claim is finally finished, American Fidelity denies the claim.
A common tactic for disability insurance companies is to deny initial applications/claims by claiming the file was missing information or documentation. Policyholders call us very upset when they are denied the very benefits they thought would be there to protect them when they became unable to work due to an injury or illness. Many are upset or downright angry at American Fidelity for its delays and denials. That’s why it is important to have an experienced long-term disability attorney assist you in explaining to you the reasons for the insurance company’s denial, and what you can do to fight back and win your claim.
At the Ortiz Law Firm, we know how difficult it can be to deal with all the paperwork associated with filing a long-term disability claim and proving the loss. You have enough to deal with in treating your injury or illness. We also know how important these benefits are to you and your family when you are unable to work and earn an income. Let us take on the burden of fighting the insurance company.
With more than a decade of experience in dealing with insurance companies, our American Fidelity long term disability lawyer has the skills and knowledge needed to help you understand your rights under your policy in order to pursue the benefits you deserve.
Filing a Successful Appeal When Your American Fidelity LTD Claim Has Been Denied
In the end, insurance companies exist to make money. They do so by collecting more in premiums than they pay out in benefits. The fewer payouts they make on claims, the more profits they keep for shareholders. If you understand this basic premise, you will have a greater understanding of why even the best-prepared disability claims can be denied. It is not personal to you. If you receive a denial letter in response to your application for benefits, do not despair and give up. You have the right to file one or more appeals directly with American Fidelity through its internal appeals review process. After you have “exhausted” your appeals, you have the right to file either a claim in State Court or an ERISA lawsuit in Federal Court.
Note: if you have an individual policy you purchased on your own (outside of a group plan), or if you are a government employee or member of a church plan, you may be exempt from ERISA regulations and have the right to file your lawsuit in state court, which affords greater protection in disability claims to you the consumer than an ERISA claim in federal court. This is why it is important to hire an attorney to explain your legal options to you.
The legal team at the Ortiz Law Firm offers detailed advice to their clients throughout the appeals process, and will help you:
- Understand the reasoning behind your long term disability claim denial;
- Acquire additional medical records and evidence to file with the appeal;
- Obtain opinions from your treating doctors with respect to your impairments resulting from your injury or illness;
- Complete the appeals paperwork;
- File your LTD claim appeal within the required time limits;
- Filing an ERISA lawsuit in federal court (or a breach of contract lawsuit in state court); and
- Prepare your case for trial.
While there are no guarantees that the appeal of your claim will be approved on the first try, we will work diligently to help you file a claim that is clear and concise, and complete with all necessary information. Mr. Ortiz has represented hundreds of claimants in long-term disability insurance claims, and he has lots of experience in representing disability applicants who have had their claims denied, delayed, or terminated. Contact our office online or call (888) 321-8131 to schedule a free case evaluation to discuss your individual American Fidelity LTD claim.