Reliance Standard Life Insurance Company is a member of the Tokio Marine Group. Reliance Standard, together with sister company Matrix Absence Management (Matrix), provides a full range of short term disability and long term disability (LTD) benefits.
Disability insurance products and services are offered by Reliance Standard in all states (except New York), the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. In New York, LTD insurance products and services are offered by First Reliance Standard Life Insurance Company. Unfortunately, Reliance Standard Disability Insurance denied claims are much more common than approvals. If your disability claim with Reliance Standard or First Reliance has been denied, you can contact us for assistance.
Reliance Standard Disability Claims Review Process
Once you file a claim for Reliance Standard disability benefits, whether it be for long term or short term disability, a claims representative will evaluate your application. A representative for the insurance company may contact you and solicit information about your activities of daily living, self-reported symptoms, and the facts and circumstances of any Social Security disability claims you may have.
You can use the contact information below to submit your claim for disability:
Reliance Standard Life Insurance Company
P.O. Box 8330
Philadelphia, PA 19101-351-7500
(267) 256-4262 (Fax)
If your claim for disability has been denied you can appeal by submitting your request in writing to:
Reliance Standard Life Insurance Company
Quality Review Unit
P.O. Box 8330
Philadelphia, PA 19101-8330
If you are approved, you will receive long term disability insurance benefits. If Reliance Standard sends you a claim denial letter or terminates benefits, then you must go through the internal appeals review process. If you go through the appeal process, Reliance Standard typically uses outside medical reviewers. These third-party vendors are supposed to conduct an “independent” medical exam. However, there is little evidence that these independent medical reviews are based on proper medical criteria. It is common for such outside doctors retained by Reliance Standard to discount or disregard the disabling effects of pain, fatigue, and the side effects of medication.
How Reliance Standard Defines Disability
There are no specific disability laws that determine what is and is not a disability in disability insurance claims. The definition for the term “disability” will be specifically defined in your long term disability policy with Reliance Standard. Thus, you should look at your own policy to determine how that term will be used in your disability claim. However, it is still useful to see how Reliance Standard has defined disability in the past. A Reliance Standard policy was detailed in a recently published court opinion:
As defined by the Policy, to qualify for disability during the initial 24-month period of coverage, an Insured must demonstrate an inability to perform material duties of her regular occupation. To qualify for benefits after 24 months, a claimant must be unable to perform the duties of “any occupation” which is defined as an inability to perform the material duties of any occupation that her education, training, or experience reasonably allow. In addition, under the Mental or Nervous Disorders Limitation, benefits are not payable beyond 24 months for any disability that is caused by or contributed to by a mental disorder, including anxiety and depression.
Reasons Why Reliance Standard Denies Claims
It is not unusual for Reliance Standard to issue an insurance claim denial or termination rather than paying a disability insurance claim. For example, Reliance Standard may issue a disability insurance denial due to a pre-existing condition or terminate after a period of two years. It is not unusual for a disability claim to be initially approved and then denied after two years, and the video below explains the top reasons why Reliance Standard denies disability insurance claims. If you received an insurance claim denial after receiving benefits for 24 months the following video will help you understand why.
ERISA and Long Term Disability Insurance
Federal ERISA employee benefits laws heavily favor insurance companies like Reliance Standard and are not very consumer-friendly with individual claimants. The type of coverage afforded by a disability insurance policy is governed by the disability policy. In other words, the most important document in the entire process is the disability insurance contract which defines the type of coverage to be provided and the duties and responsibilities of all parties to the contract (i.e., the claimant and the insurance company).
A long term disability policy can be very complex. It may be hard for a layperson to understand the terms of the contract and when a claimant is entitled to disability coverage. If you are the claimant and your insurance company is refusing to pay your disability benefits, an experienced ERISA lawyer can help you recover the benefits you deserve under your disability insurance policy.
Lawsuits Against Reliance Standard
The following cases were not handled by Nick Ortiz, but have been summarized to provide a better understanding of how disability law is interpreted and how the Court decides such lawsuits in federal court:
Why You Need a Long Term Disability Insurance Lawyer
You may need legal help in order to obtain your disability income benefits from Reliance Standard. Disability insurance policies are insurance contracts that are usually very complex and hard to understand. Moreover, LTD policies are often subject to change and written in favor of the insurance company. ERISA laws that govern group disability policies are also complicated and favor insurance companies.
A seasoned and experienced long term disability attorney can help you navigate the complex ERISA rules and regulations. The Ortiz Law Firm can make sure you understand your policy, understand how ERISA laws work, help you with the claims and denial process, and fight for your rights in a lawsuit against Reliance Standard. We won’t give up until we have recovered the long term disability benefits that you deserve.
If you receive a claim denial, one of the most important things you can do is prepare a good appeal. Disability appeals are not only important to reverse a denial, but they are important to strengthen the administrative record prior to filing a lawsuit. If it later becomes necessary to file a lawsuit, the court will only review the medical records that were submitted during the administrative review process. Since you are so limited by the appeals process we recommend that disability claimants request a free consultation with a disability attorney before moving forward on their own.[Note: an internal appeal may not be necessary for some policyholders, such as those with an individual policy. That’s why you should consult with an experienced disability attorney before further communicating with Reliance Standard about your denied insurance benefits claim.]
How Can an Attorney Help me Appeal?
Most employer-sponsored long term disability plans are regulated by ERISA, which is a federal law. Under ERISA, an individual who has been denied long term disability benefits has 180 days after receipt of the written denial letter to submit information to support the claim. This evidence is critical. That’s because a Federal Court usually will not accept or consider new evidence submitted during the course of the lawsuit. Instead, the Federal Court is limited to seeing what was in the administrative record at the time the insurance adjuster made his or her decision. Therefore, all relevant evidence and documentation in support of the disability claim should be submitted to the insurer or disability plan administrator for the initial administrative appeal.
If you hire the Ortiz Law Firm to represent you as your attorney on an administrative appeal, we will obtain the complete claim file, conduct a medical review, and evaluate all the medical, factual, and vocational evidence considered by the insurance company. However, we usually go further by seeking medical and vocational opinions, such as a residual functional capacity form, to support your claim to make sure that we have the best chance of reversing your disability insurance benefits claim denial. We will help you document the evidence that supports a favorable disability determination, based on the policy or group disability plan document. We represent disability insurance claimants anywhere in the United States. Contact us at (888) 321-8131 or contact us online to request a free consultation.