Reliance Standard Life Insurance Company is a member of the Tokio Marine Group, a multinational insurance holding company. Reliance Standard, together with its sister company, Matrix Absence Management (Matrix), provides a full range of short-term disability and long-term disability benefits. Disability insurance products and services are offered by Reliance Standard Life Insurance Company in all states (except New York), the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. In New York, long-term disability (LTD) insurance products and services are offered by First Reliance Standard Life Insurance Company.
Unfortunately, Reliance Standard Disability claim denials are much more common than approvals. If your disability claim with First Reliance or Reliance Standard has been denied, you can contact us for assistance. A disability attorney at our firm can review your disability denial from Reliance and advise you as to how we can help with the administrative appeal process with Reliance Standard Life Insurance Company. If necessary, a disability attorney at our firm can also assist you with filing a lawsuit against Reliance Standard Life Insurance Company.
Reliance Standard Disability Claims Review Process
Once you file a claim for Reliance Standard disability insurance benefits, whether it be for long-term disability or short-term disability benefits, a Reliance Standard disability claim representative will evaluate your application. A disability claim representative for Reliance Standard Life Insurance Company may contact you and solicit information about your activities of daily living, self-reported symptoms, and the facts and circumstances of any other disability claims with other insurance companies or Social Security Disability Insurance claims you may have filed.
Contact Information for New Claims
You can use the contact information below to submit your Reliance Standard disability claim to the insurance company:
Reliance Standard Life Insurance Company
P.O. Box 8330
Philadelphia, PA 19101-351-7500
Contact Information for Appeals
If your disability claim has been denied by Reliance Standard you can appeal by submitting your request in writing to the following address. However, if your denial letter provides a different address, then you should send your appeal to the address provided by Reliance Standard Life Insurance Company:
Reliance Standard Life Insurance Company
Quality Review Unit
P.O. Box 8330
Philadelphia, PA 19101-8330
What Happens Next
If your disability claim is approved, you will receive long-term disability insurance benefits from the insurance company. If Reliance Standard sends you a long-term disability benefits denial letter, then you must go through the internal appeals review process with the insurance company. If you go through the appeal process, Reliance Standard typically uses outside medical reviewers to assist with the processing of your long-term disability claim.
Outside Medical Reviewers
These third-party vendors are supposed to conduct an “independent” medical exam or medical review to determine if you are eligible to receive long-term disability benefits. 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 Life Insurance Company to discount or disregard the disabling effects of pain, fatigue, and the side effects of medication in order to deny long-term disability insurance claims.
How Reliance Standard Defines Disability
There are no specific disability laws that determine what is and is not considered a disability in long-term 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 with Reliance Standard Life Insurance Company.
However, it is still useful to see how Reliance Standard has defined disability in the past. The following policy excerpt is from a policy issued by Reliance Standard Life Insurance Company that was detailed in a 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.
Reliance Standard Disability Claim Denials
It is not unusual for Reliance Standard to issue a long-term disability insurance claim denial or termination letter rather than paying long-term disability benefits. For example, Reliance Standard may issue a disability insurance claim denial due to a pre-existing condition or terminate a disability claim after a period of two years.
It is not unusual for a disability claim to be initially approved and then cut off after two years, and the video below explains the top reasons why Reliance Standard denies disability insurance claims. If you received a long-term disability insurance claim denial after receiving benefits for 24 months the following video will help you understand why.
Top Reasons Why Reliance Standard Denies Disability Claims
ERISA and Long Term Disability Insurance Claims
Most employer-sponsored long-term disability plans are regulated by the Employee Retirement Income Security Act, which is a federal law. Federal Employee Retirement Income Security Act (ERISA) laws heavily favor insurance companies like Reliance Standard and are not very consumer-friendly with individual claimants. Under ERISA, an individual who has been denied long-term disability benefits has 180 days after receipt of the disability insurance claim denial to submit information to support the disability claim.
This evidence is critical, and 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 decided your long-term disability claim. Therefore, all relevant evidence and documentation in support of your disability claim should be submitted to the insurer or disability plan administrator with the initial administrative appeal.
Why You Need a Long Term Disability Insurance Lawyer
If you have received a denial from Reliance Standard you may need legal help in order to obtain your long-term disability insurance benefits from Reliance Standard. 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 Reliance Standard disability insurance policy.
How Can an Attorney Help With the Appeal of My Long-Term Disability Insurance Claim Denial?
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.
Understanding Your Coverage
Disability insurance policies are insurance contracts that are usually very complex and hard to understand. 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).
Moreover, long-term disability insurance policies are often subject to change and written in favor of the insurance company. The type of coverage afforded by a disability insurance policy is governed by the disability policy, so we will make sure you understand the terms of your policy.
Preparing Your Appeal
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 with their long-term disability claim on their own. 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 records and vocational evidence considered by Reliance Standard disability insurance company.
Obtaining Additional Evidence
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.
Determining If You have to Appeal At All
Note: an internal appeal may not be necessary for some policyholders, such as those with an individual policy. This is because individual policies are not governed by ERISA laws. That’s why you should consult with an experienced disability attorney before further communicating with Reliance Standard or any other insurance companies about your denied long-term disability claim.
Lawsuits Against Reliance Standard Life Insurance Company
If Reliance Standard denied your administrative appeal (or if your initial claim was denied and you have an individual policy that is not governed by ERISA) then you have the option to file a lawsuit against Reliance Standard for denying your claim.
The following Reliance Standard disability claims were not handled by Ortiz Law Firm, but have been summarized by our to provide a better understanding of how disability law is interpreted and how the Court decides such disability claim lawsuits in federal court:
Request a Free Consultation with a Long-Term Disability Attorney
If Reliance Standard denied your claim for long-term disability benefits, the disability lawyers at Ortiz Law Firm can help. Our disability lawyers represent disability insurance claimants anywhere in the United States and will take on Reliance Standard and any other major insurance companies.
Let Ortiz Law Firm fight for the Reliance Standard disability benefits you deserve. Call us at (888) 321-8131 to request a free consultation to discuss your claim for long-term disability benefits with an experienced disability lawyer.