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With almost $20 billion in annual income (and a internet revenue of $1.4 billion in 2021), Lincoln Monetary Group is well one of many largest monetary companies and insurance coverage firms in the USA. And when it acquired Liberty Life Assurance Firm of Boston in 2018, it grew to become America’s largest supplier of totally insured incapacity insurance policies within the nation. in case you have a gaggle long-term disability or short-term disability coverage, there’s a first rate probability Lincoln Monetary issued it.
After all, insurance coverage firms typically don’t develop to the scale of Lincoln Monetary by all the time paying out full incapacity advantages to each claimant. Denying and delaying claims is sweet for the underside line—and Lincoln Monetary has a protracted historical past of doing each.
In case you have been on the mistaken finish of an unfairly denied incapacity declare, you understand how devastating it will possibly really feel. However an preliminary denial doesn’t should be the top of the story. At Bryant Authorized Group, now we have in depth expertise dealing with Lincoln Monetary incapacity insurance coverage claims. We might help you perceive why your declare was denied, clarify your authorized rights, and deal with your enchantment.
Denied, Delayed, and Even Misplaced Claims Are Nothing New for Lincoln Monetary Group
Like different massive monetary and insurance coverage establishments, Lincoln Monetary has a protracted historical past of defending itself—not all the time efficiently—in opposition to authorized claims of wrongdoing. The corporate has paid thousands and thousands to settle instances the place claimants’ rightful incapacity advantages or life insurance coverage advantages had been unfairly withheld.
In some of the excessive examples of the final 20 years, Lincoln Monetary really misplaced no less than 4,000 insurance coverage claims after a merger. Though Lincoln found the error in 2008, it didn’t do something about it till after a 2015 investigation by the New York Division of Monetary Providers—greater than six years later.
Our personal private expertise paints the same image. We deal with quite a lot of Lincoln Monetary incapacity denial instances, and we steadily discover enormous gaps and lacking medical information throughout the administrative evaluate course of. You might need signed a understand authorizing a incapacity insurance coverage to evaluate your medical information, however that doesn’t imply they are going to really take a look at them. They don’t seem to be going to go digging for information that damage their very own case.
The easy conclusion: the insurance coverage firm isn’t in your aspect. Earnings come first. If they’ll assemble an excuse to keep away from paying advantages to guard their backside line, they are going to. Lincoln Monetary is definitely not distinctive on this regard, however they’re additionally not an exception.
Widespread Causes Incapacity Claims Are Denied
After all, an insurance coverage firm can’t merely refuse to pay out promised advantages simply because they don’t really feel prefer it. They wouldn’t keep in enterprise. They should present some justification.
However that doesn’t imply each denial is official. Some are, but when there may be any ambiguity over the interpretation of the very fact or of a coverage, the insurance coverage firm is probably going to offer themselves the advantage of the doubt.
Under, we take a more in-depth take a look at a number of the most typical causes that Lincoln Monetary incapacity claims are denied—together with denials for each short-term disability benefits and long-term disability benefits.
Denied Quick-Time period Incapacity Claims
Typically, short-term incapacity insurance coverage claimants are much less more likely to contest a denied declare than long-term incapacity claimants. It might not appear well worth the bother for many who plan to be again to work in a number of weeks or months.
Insurance coverage firms know this and should use it to their benefit when denying claims.
Among the most typical causes for denial embody:
- Inconsistent statements or behaviors. The insurance coverage firm will fastidiously evaluate all supplies you submit, and would possibly even comply with your social media posts or rent a non-public investigator, to search for proof that you just misrepresented your damage.
- Lack of medical proof. You have to to supply medical proof outlining your analysis and signs. Nevertheless, the insurance coverage firm might attempt to declare that what you offered isn’t adequate proof.
- Claiming you aren’t disabled or solely partially disabled. Your Lincoln Monetary incapacity insurance coverage coverage would possibly solely pay advantages when you’re “completely” disabled. The insurance coverage firm would possibly declare that their analysis signifies you’re nonetheless able to performing a few of your duties or might delegate a few of your duties briefly.
- Points together with your preliminary software. If there are any inaccuracies or misrepresentations in your authentic software for short-term incapacity insurance coverage—for instance, you didn’t establish a related pre-existing situation—the insurance coverage firm might use this as grounds to disclaim your declare or query your credibility.
- Particular exclusions. Your coverage would possibly particularly exclude sure circumstances, resembling pre-existing circumstances, self-inflicted accidents, or accidents that end result from high-risk hobbies or actions.
Denied Lengthy-Time period Incapacity Claims
Corporations like Lincoln Monetary reject long-term incapacity insurance coverage claims for lots of the identical causes they deny short-term advantages, together with all those described above: like inadequate proof, paperwork errors, inconsistent statements and surveillance.
One added hurdle widespread to long-term incapacity claims is the definition of incapacity. Most employer-provided group long-term incapacity insurance policies use an “any occupation” definition, that means that you’re solely eligible for long-term advantages when you can’t work any job. So, even when you can now not proceed in your chosen profession, your declare should be denied if the insurance coverage firm believes you might be succesful and certified to deal with different full-time work—even low paying and unfulfilling occupations.
This may occasionally catch claimants unexpectedly in the event that they anticipate to have the ability to transition straight from short-term incapacity to long-term incapacity. Quick-term incapacity insurance policies virtually all the time use an “own occupation” definition of incapacity, that means you solely want to point out you can not work your present job. Should you at the moment carry out high-wage or high-skill work, we strongly suggest you buy a long-term incapacity plan that additionally makes use of an personal occupation definition each time potential.
Keep in mind: simply because your short-term advantages had been authorized doesn’t assure your long-term advantages might be.
What to Do If Lincoln Monetary Denies Your Incapacity Insurance coverage Declare: The Enchantment Course of
If the insurance coverage firm denied your incapacity declare, you’ve gotten a proper to enchantment that call.
Most Lincoln Monetary incapacity insurance policy are ruled by ERISA, a legislation that applies to all employer-provided insurance policy with few exceptions. This implies that you will want to undergo an administrative enchantment course of straight with Lincoln Monetary earlier than you’ll be able to file a lawsuit. (In truth, most Lincoln Monetary group insurance policies require two administrative appeals.)
It’s critically vital to take these appeals severely and be sure you embody all of the paperwork and proof you want. In case your enchantment goes to courtroom, the choice might be made based mostly on the identical information out of your administrative enchantment. In different phrases, you normally can’t add any new proof that wasn’t already offered in your declare file.
Right here’s a fast appeals course of guidelines, however be sure you click on the hyperlink under for extra particulars:
- Evaluation your denial letter to establish the rationale the insurance coverage firm denied your declare. (Beneath ERISA, it’s best to obtain an preliminary resolution inside 45 days of submitting your declare.)
- Evaluation your insurance coverage coverage’s enchantment procedures and deadlines. Mark the submitting deadlines in your calendar.
- Seek the advice of a incapacity insurance coverage lawyer who can educate you about your enchantment choices.
- Request a duplicate of your declare file from the insurance coverage firm or third-party administrator in your employer’s incapacity profit plan.
- Decide whether or not the declare file is lacking details about your medical circumstances and incapacity declare.
- Order the related information and supply them to the insurance coverage firm.
- Write an in depth enchantment letter and ship it earlier than your enchantment deadline.
- Evaluation the insurance coverage firm’s last resolution and assess your authorized choices.
How Bryant Authorized Group Can Assist With Your Lincoln Monetary Incapacity Enchantment
Since you solely have a restricted time to file an enchantment, and in lots of instances, you solely get one probability so as to add new proof to the file, dealing with your enchantment by yourself is a dangerous alternative. Even easy errors might value you your probability at profitable your enchantment. And Lincoln Monetary’s insurance coverage adjusters might be all too comfortable to allow you to make them. They’re searching for his or her income, not you.
At Bryant Authorized Group, our attorneys have in depth expertise coping with Lincoln Monetary Group incapacity instances. We’re accustomed to their coverage language, the methods they use to keep away from paying advantages, and in lots of instances even the attorneys that they use to defend in opposition to authorized claims.
Our staff can evaluate your coverage and declare file with you and provide you with an neutral, sensible evaluation of your authorized choices. Should you rent us to deal with your enchantment, we’ll deal with the paperwork, keep on prime of deadlines, and do the digging essential to be sure you’ve gathered and submitted all of the proof you want to show your incapacity. And in case your administrative enchantment remains to be denied, our skilled trial attorneys can defend your rights in courtroom when crucial.
Chicago’s Premier Incapacity Attorneys
Don’t let an insurance coverage firm like Lincoln Monetary deny you the incapacity insurance coverage advantages you deserve. Bryant Authorized Group has earned a fame as certainly one of Chicago and Illinois’ premier incapacity insurance coverage legislation companies, and we’d love the chance to evaluate your case and show you how to discover a answer.
To request your free authorized session with certainly one of our skilled incapacity insurance coverage legal professionals, please name 312-586-9650 at present or complete this brief online form.
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