With almost $20 billion in annual income (and a web revenue of $1.4 billion in 2021), Lincoln Monetary Group is well one of many largest monetary providers and insurance coverage firms in the USA. And when it acquired Liberty Life Assurance Firm of Boston in 2018, it turned America’s largest supplier of totally insured incapacity insurance policies within the nation. when you have a bunch long-term incapacity or short-term incapacity coverage, there’s a respectable probability Lincoln Monetary issued it.
In fact, insurance coverage firms typically don’t develop to the scale of Lincoln Monetary by at all times paying out full incapacity advantages to each claimant. Denying and delaying claims is nice for the underside line—and Lincoln Monetary has an extended historical past of doing each.
If in case you have been on the unsuitable finish of an unfairly denied incapacity declare, you understand how devastating it might probably really feel. However an preliminary denial doesn’t need to be the top of the story. At Bryant Authorized Group, we’ve got in depth expertise dealing with Lincoln Monetary incapacity insurance coverage claims. We will 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 giant monetary and insurance coverage establishments, Lincoln Monetary has an extended historical past of defending itself—not at all times 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 have been unfairly withheld.
In one of the vital excessive examples of the final 20 years, Lincoln Monetary really misplaced at the very least 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 Companies—greater than six years later.
Our personal private expertise paints an analogous image. We deal with loads of Lincoln Monetary incapacity denial instances, and we incessantly discover big gaps and lacking medical information through the administrative assessment course of. You may need signed a understand authorizing a incapacity insurance coverage to assessment your medical information, however that doesn’t imply they are going to really have a look at them. They aren’t going to go digging for information that harm their very own case.
The straightforward conclusion: the insurance coverage firm isn’t in your facet. Income 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.
Frequent Causes Incapacity Claims Are Denied
In fact, an insurance coverage firm can not 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 reliable. Some are, but when there’s any ambiguity over the interpretation of the very fact or of a coverage, the insurance coverage firm is probably going to provide themselves the advantage of the doubt.
Beneath, we take a more in-depth have a look at a few of the most typical causes that Lincoln Monetary incapacity claims are denied—together with denials for each short-term incapacity advantages and long-term incapacity advantages.
Denied Brief-Time period Incapacity Claims
Basically, short-term incapacity insurance coverage claimants are much less prone to contest a denied declare than long-term incapacity claimants. It might not appear definitely worth the bother for many who plan to be again to work in a couple 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 rigorously assessment all supplies you submit, and may even observe your social media posts or rent a non-public investigator, to search for proof that you just misrepresented your harm.
- Lack of medical proof. You have to to supply medical proof outlining your analysis and signs. Nonetheless, the insurance coverage firm might attempt to declare that what you supplied isn’t ample proof.
- Claiming you aren’t disabled or solely partially disabled. Your Lincoln Monetary incapacity insurance coverage coverage may solely pay advantages in case you’re “completely” disabled. The insurance coverage firm may declare that their analysis signifies you’re nonetheless able to performing a few of your duties or might delegate a few of your duties quickly.
- Points along 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 determine 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 may particularly exclude sure circumstances, comparable to pre-existing circumstances, self-inflicted accidents, or accidents that end result from high-risk hobbies or actions.
Denied Lengthy-Time period Incapacity Claims
Firms like Lincoln Monetary reject long-term incapacity insurance coverage claims for most of the similar 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, which means that you’re solely eligible for long-term advantages in case you can not work any job. So, even in case you can not proceed in your chosen profession, your declare should be denied if the insurance coverage firm believes you’re succesful and certified to deal with different full-time work—even low paying and unfulfilling occupations.
This will catch claimants unexpectedly in the event that they count on to have the ability to transition instantly from short-term incapacity to long-term incapacity. Brief-term incapacity insurance policies virtually at all times use an “personal occupation” definition of incapacity, which means you solely want to point out you can’t work your present job. For those who presently 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 doable.
Bear in mind: simply because your short-term advantages have been accepted doesn’t assure your long-term advantages will likely be.
What to Do If Lincoln Monetary Denies Your Incapacity Insurance coverage Declare: The Attraction Course of
If the insurance coverage firm denied your incapacity declare, you might have a proper to enchantment that call.
Most Lincoln Monetary incapacity insurance coverage are ruled by ERISA, a legislation that applies to all employer-provided insurance coverage with few exceptions. This implies that you will want to undergo an administrative enchantment course of instantly with Lincoln Monetary earlier than you’ll be able to file a lawsuit. (The truth is, most Lincoln Monetary group insurance policies require two administrative appeals.)
It’s critically vital to take these appeals critically and make sure to embody all of the paperwork and proof you want. In case your enchantment goes to courtroom, the choice will likely be made primarily based on the identical information out of your administrative enchantment. In different phrases, you normally can not add any new proof that wasn’t already supplied in your declare file.
Right here’s a fast appeals course of guidelines, however make sure to click on the hyperlink under for extra particulars:
- Overview your denial letter to determine the explanation the insurance coverage firm denied your declare. (Underneath ERISA, you need to obtain an preliminary resolution inside 45 days of submitting your declare.)
- Overview 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 replica of your declare file from the insurance coverage firm or third-party administrator to 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.
- Overview the insurance coverage firm’s closing resolution and assess your authorized choices.
How Bryant Authorized Group Can Assist With Your Lincoln Monetary Incapacity Attraction
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 report, dealing with your enchantment by yourself is a dangerous selection. Even easy errors might price you your probability at successful your enchantment. And Lincoln Monetary’s insurance coverage adjusters will likely be all too blissful to allow you to make them. They’re looking 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 conversant in 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 crew can assessment your coverage and declare file with you and provide you with an neutral, sensible evaluation of your authorized choices. For those who rent us to deal with your enchantment, we’ll deal with the paperwork, keep on high of deadlines, and do the digging essential to be sure you’ve gathered and submitted all of the proof it’s worthwhile to show your incapacity. And in case your administrative enchantment continues to be denied, our skilled trial attorneys can defend your rights in courtroom when essential.
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 status as considered one of Chicago and Illinois’ premier incapacity insurance coverage legislation corporations, and we’d love the chance to assessment your case and provide help to discover a resolution.
To request your free authorized session with considered one of our skilled incapacity insurance coverage legal professionals, please name 312-586-9650 right now or full this transient on-line kind.
