Employee Retirement Income Security Act (ERISA)<\/a>.<\/p>\n\n\n\nWhen you purchase new car insurance, typically, the first thing that they\u2019ll send you is a summary of coverage often called a declaration page or a one to two-page letter that summarizes the types of coverages that you have. After that, typically, you are also given a thicker booklet that comes in the mail and might be 30, 40, or 50 pages long, and most of us just file it away. That\u2019s your actual policy that details the entire contract.<\/p>\n\n\n\n
The same thing occurs in a long term disability claim. The SPD is a written document that provides a summary of the key features of an employee benefit plan, including a long-term disability plan. It must be provided to plan participants and beneficiaries, and it includes information about how the plan works, what benefits are available, how to file a claim for benefits, and other important details. Underlying the summary is the actual plan or policy.<\/p>\n\n\n\n
I can tell you that in most instances in a long term disability case, that policy is between 20 and 50, maybe even 100 pages long. It sets out what your rights are under the policy, it spells out the benefits that you\u2019re entitled to, but perhaps most importantly, it also shows what your burden of proof is and what you have to show in order to get your benefits. That\u2019s why it\u2019s extremely important for you to get a copy of this. Most of our clients don\u2019t have a copy of the policy when they call us.<\/p>\n\n\n\n
Under ERISA, the SPD must be written in a clear and understandable manner, and it must accurately reflect the terms of the plan document. If there is a conflict between the SPD and the plan document, the plan document will generally control. If the SPD and the LTD policy conflict, then you want to determine which provision the insurance company relied on in issuing its determination. Again, the full LTD policy or plan should control over the SPD, but some court cases have ruled in favor of plan participants where they demonstrated that they reasonably relied upon a provision in the SPD.<\/p>\n\n\n\n
In sum, that\u2019s why it\u2019s extremely important for you to get a full copy of your long term disability insurance policy. You can follow the process outlined above to obtain your policy. If you\u2019ve been denied long term benefits, then I encourage you to give us a call at\u00a0(888) 321-8131<\/a><\/strong>. Or, if you prefer to review some additional information, you can request a free copy of a book I wrote called the\u00a0\u201cTop 10 Mistakes That Will Destroy Your Long Term Disability Claim\u201d.\u00a0<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"At the end of the day, a long-term disability claim is governed by a contract. You, perhaps through your employer, but with an insurance company, have an agreement where if you\u2019re unable to work they\u2019re to pay you benefits under the disability plan. Most people, when they\u2019re given this type of benefit through their employer, they receive …<\/p>\n","protected":false},"author":2,"featured_media":5497,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[207],"tags":[],"_links":{"self":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/3284"}],"collection":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/comments?post=3284"}],"version-history":[{"count":0,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/posts\/3284\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/media\/5497"}],"wp:attachment":[{"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/media?parent=3284"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/categories?post=3284"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nickortizlaw.com\/wp-json\/wp\/v2\/tags?post=3284"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}