If you are covered by disability insurance and have been rendered unable to work due to having suffered a short-term disability, then you are entitled to submit a claim and receive benefits. Short-term disability benefits are temporary and are intended to provide a replacement income to tide you over until you are no longer disabled. Unfortunately, despite the fact that many disabilities (short-term included) are quite serious, insurance companies routinely deny and delay claims, terminate existing benefits, and otherwise impede their claimants’ ability to receive full and adequate benefits.
Appealing a Denial
If your claim has been denied, you are entitled to information relating to why the insurance company denied the claim. Consulting with a qualified Houston short-term disability lawyer is critical at this juncture, as there is a deadline by which your appeal must be submitted. Your attorney will help you collect the necessary evidence for submitting an appeal and develop a persuasive argument — based on such evidence — as to why you are entitled to benefits..
Wrongful Denial or Bad Faith
In Texas, as in other states, insurance providers are required to act in good faith when handling long-term and short-term disability claims. If the insurer has acted in bad faith in denying your disability claim — in other words, if they have acted improperly or unreasonably — then you may be entitled to sue and recover damages. However, this remedy is not available if your short term disability benefits are governed by ERISA.
Wrongful conduct includes, but is not necessarily limited, to:
- Delaying payment of benefits
- Denying benefits when the evidence clearly justifies payment
- Intimidating or otherwise coercing the claimant
- Terminating benefits prematurely
Depending on your insurance policy, short-term disability coverage may cover either a specified period of time (i.e., three months, six months, or up to a year) or will last until you are sufficiently recovered to return to work. Given the short-term nature of such benefits, unscrupulous insurers will sometimes delay benefits or deny benefits so as to exhaust the claimant’s interest in obtaining benefits.
Though short-term disability benefits are temporary, insurance companies are accustomed to denying such claims and making it difficult for disability claimants to obtain the benefits necessary to replace or otherwise supplement their income for a limited period of time. Even if you have succeeded in obtaining short-term disability benefits, your insurer may challenge the length of such benefits by terminating them prematurely.
Here at Berg Plummer Johnson & Raval, LLP, we understand that disability claimants are already challenged by the task of having to overcome their injuries and return to the workplace within a reasonable timeframe. Often, disability claimants struggle with persistent stress related to both their injuries and their career being put on-hold. Our Houston short-term disability lawyers have decades of combined experience handling disability claims, from gathering documentation to submitting claims and appeals to filing suit.
Given that many disability claimants have a limited budget and specific strategic goals, we work closely with clients to provide dynamic fee arrangements that are designed to cost-effectively achieve positive results.