Wagar Law, P.A. is comprised of disability lawyers with experience in handling individual disability insurance claims, including applications for benefits, lump-sum buy-outs, appeals of denials of legitimate claims and litigation in both state and federal court. You should file a claim for disability income benefits when you are unable to work based on a mental and/or physical condition. However, your policy may have limitations on a mental nervous condition claim, and as such, it is important that you understand all of the terms of your policy.
Filing a claim for disability income benefits may appear to be a simple task. But, the application for benefits does not ask all of the questions to which the insurance carrier intends on obtaining answers. Thus, the carrier will delay paying or processing your claim under the guise that it needs additional information and documentation and will attempt to wear you down with the goal of having you abandon your claim.
The lawyers at Wagar Law, P.A. know the carrier’s games and will assist you in moving your claim forward in a timely and efficient manner. Furthermore, insurance carriers commonly deny legitimate claims after manipulating the facts, conducting surveillance and/or requiring you to undergo an independent medical evaluation (IME) or functional capacity evaluation (FCE), which they may or may not have the right to do or which they may do in a manner inconsistent with the policy terms or the law. Insurance carriers dedicate an enormous amount of time, money and resources to the processing of a claim in order to attempt to legitimize its denial of benefits.
Your individual disability insurance policy is regulated by state law. Thus, if your claim is denied and you exhaust any required appeals of the carrier’s denial of benefits, (typically one appeal), then you have the right to file a lawsuit under state law in state or federal court and have a jury trial. The common claims against the insurance carrier are breach of contract and bad faith. A breach of contract claim is brought against the insurance carrier when it fails or refuses to pay or settle a claim in violation of the terms of the policy.
Damages are typically limited to the payment of any back benefits, reinstatement of benefits and interest on the back benefits and possibly the recovery of a reasonable attorney’s fee. A bad faith claim under Florida law is filed when the carrier acts fraudulently or wrongfully denies or fails to settle a legitimate claim. A claim for bad faith may entitle you to punitive damages and recovery of a reasonable attorney’s fee and cost of litigation in addition to your monthly benefits. It is important that you understand the terms of your policy and the law and that you defend your rights by consulting with an experienced attorney.