Robert J. Boumis  |  January 28, 2014

Category: Consumer News

Top Class Actions’s website and social media posts use affiliate links. If you make a purchase using such links, we may receive a commission, but it will not result in any additional charges to you. Please review our Affiliate Link Disclosure for more information.

how to appeal denied insuranceWhen a large insurance company like Unum denies your long-term disability (LTD) claim, you may feel powerless. Large corporations like Unum have a way of making their determinations feel final.

However, it is important to remember that regardless of the situation, you still have rights. Most insurance companies have an internal appeals process, which must be exhausted before seeking legal solutions. If you feel your LTD claim is denied wrongly, you must take several steps to appeal your case.

Here are five ways to help you appeal a denied insurance claim:

Gather Information

First, you need to get several critical pieces of information. Most importantly, you need to make sure you’re aware of every deadline. Many internal rules, as well as legal remedies, have a rigid timeline that you must work within. But these deadlines aren’t the only type of information you need to proceed. You must also procure as much information about the denial. Collect all information from the denied claim, and press the company for additional information. Some critical questions include:

  • Which specific policy clauses led to the long term disability claim denial?
  • What occupation does the company believe you can perform?
  • What job description are they using?
  • What documentation or proof do they feel is lacking? What do they need?

Follow Procedure

You need to keep a cool head and continue to follow the rules. Document every contact you have with your insurance company, in case you take legal action later. Never let anger of frustration determine your actions. While the situation may be frustrating or threatening, acting out of anger can make things much worse. Remember that every communication you have with the insurance company is an effort to obtain information, and remain true to this ultimate mission.

Documentation

After you know the reasons behind your long term disability claim denial, you need to get information that will fill the gaps. For example, if they need more medical documentation, you should start keeping a journal  of your symptoms, and get a detailed letter from your doctor explaining your illness and symptoms. You can even ask family members to write up statements of how your symptoms have affected your daily life. Since most LTD claims involve the inability to work, ask your last employer for a statement regarding how your illness has affected your work. In all of these statements, you must remember that the devil is in the details. Specifically, you must make sure your statement captures as much detail as possible.

File Your Appeal

Once you’ve amassed all of your documentation, write an appeal letter. Make sure it’s in compliance with any format the insurance company needs. First, write up an overview of the situation, explaining how the evidence shows that you are disabled per the policy’s terms. Again, keep a cool head and do not make any insulting or attacking comments. You must also avoid threats. Just CCing the document to your attorney and your state’s insurance commissioner is sufficient to show your resolve. Once you’ve sent them your appeal, wait a few weeks, then call and make sure the materials have been received. You may have to go through the appeals process more than once.

Consider Legal Action

If your appeals are denied—and many insurers have a set number of appeals—you may need to seek legal action. Many lawsuits have been filed against companies like Unum, seeking the reinstatement of insurance benefits.

In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or class action lawsuit is best for you. Hurry — statutes of limitations may apply.

Learn More

We tell you about cash you can claim EVERY WEEK! Sign up for our free newsletter.


Get Help – It’s Free

Get Help With Your Long Term Disability Insurance Appeal

If you were denied a disability claim or had your disability benefits terminated without reason, you may be able to take legal action. See if you qualify by filling out the short form below.

An attorney will contact you if you qualify to discuss the details of your potential case at no charge to you.

  • The law firm responsible for the content of this page is: The Wilkins Law Firm, PLLC
  • Please note that if you were not denied by at least one of these companies, you will not qualify for this investigation.
  • We tell you about cash you can claim every week! Subscribe to our free newsletter today.
    By checking this box, I consent to receive from Top Class Actions marketing emails and/or marketing calls or text messages sent by an automatic telephone dialing system. I consent to Top Class Actions providing my phone number and email address to the lawyers or their agents sponsoring this investigation, and their co-counsel, if any, and I consent to receive marketing calls, text messages, and/or emails from those lawyers or their agents. I understand that this authorization overrides any previous registrations on a federal or state Do Not Call registry. You may opt out at any time. You can review Top Class Actions' Terms and Conditions and Privacy Policy here.
  • This field is for validation purposes and should be left unchanged.

Please note: Top Class Actions is not a settlement administrator or law firm. Top Class Actions is a legal news source that reports on class action lawsuits, class action settlements, drug injury lawsuits and product liability lawsuits. Top Class Actions does not process claims and we cannot advise you on the status of any class action settlement claim. You must contact the settlement administrator or your attorney for any updates regarding your claim status, claim form or questions about when payments are expected to be mailed out.