Chicago Disability Attorney

When you’re in the middle of a long-term disability (LTD) or ERISA dispute, the insurance company might offer you a settlement or buyout. While this offer might seem generous (and tempting) at first, you should be cautious. Insurance companies rarely offer a fair settlement in their first offer — and you could lose out on valuable compensation if you accept.

In this article, Bryant Legal Group outlines the essentials of disability insurance settlements and when it’s best to accept a lump-sum payment.

What Is a Long-Term Disability Settlement or Buyout?

When the insurance company approves your LTD claim or a court grants your benefits, you should receive these payments on a monthly basis. If your condition does not improve, these benefits might continue until you reach retirement age. That’s a significant financial obligation for the insurance company, and they’d love to cut these costs.

When you settle your ERISA claim, you give up your right to ongoing benefits in exchange for a lump-sum payment. Once you accept a buyout and the insurance company issues you a check, you will no longer receive any disability insurance benefits — and, if you change your mind, you cannot go back and demand more compensation at a later date.

When Should I Settle My LTD Claim?

Every ERISA claim is different, and there are no simple cookie-cutter answers to when you should settle. Instead, you should consider a series of factors and priorities:

  • Age and life expectancy
  • Financial security and other sources of income
  • Likelihood of returning to work
  • The strength of your claims (if the company is disputing your eligibility for benefits)
  • Whether the offer is reasonable

At Bryant Legal Group, we guide people with disabilities through this analysis, focusing on their unique situation and goals. We believe that you should only settle your ERISA claim when it’s in your best interest and you fully understand the complications of a buyout.

We provide our clients with the time and information they need to make sound decisions. We also fiercely advocate for them, fighting on their behalf to ensure a fair lump-sum payment.

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4 Considerations Before You Settle Your ERISA Claim

While everyone should consult with an ERISA lawyer to get a personalized analysis of their claim, there are a few key considerations in any disability insurance settlement.

1. What Is Your Age and Life Expectancy?

Because you might receive disability insurance benefits for a lifetime (or until you reach retirement age), your age and life expectancy will significantly impact the value of your LTD claim. When you die, your benefits will end.

If you are a younger person with a high life expectancy and you cannot return to work, your lifetime of benefits will carry a significant value. For example, suppose you become disabled at age 45 and remain eligible for LTD benefits for 20 years. If your LTD benefit is $2,500 per month, you would get $600,000 in total LTD payments. Unless the insurance company offers you a large buyout, it will likely be in your best interest to receive ongoing benefits.

However, if you’re an older person or are facing a terminal or life-threatening condition, a lump-sum settlement might provide you with a nest egg for your loved ones after your death.

2. What Is Your LTD Claim’s Present Value?

While your LTD claim might be worth $600,000 over 20 years, that is not its “present value.” Money is worth more today than it will be in 10 years — due to inflation and other factors.

Suppose you win $1 million in the lottery. You get two options: receive payments over time or take a lump sum. If you choose monthly payments, you’ll receive $4,000 per month for 20 years. However, if you accept the lump sum, you’ll get a check for $700,000 because when you add in interest and inflation, those monthly payments have the same value as $700,000 today.

When actuarial scientists and banks calculate present value, they must identify the appropriate rate of return and your expected duration of benefits. It’s a complicated process that is best left to the experts.

However, don’t assume that the insurance company’s present value calculations are accurate. Insurers frequently undervalue claimants’ benefits, trying to convince them to take a smaller lump sum. An experienced ERISA lawyer will consult with financial specialists who can properly calculate your claim’s present value and respond to the company’s offers.

3. Will You Pay Taxes on Your Buyout?

A settlement from some disability plans, such as those you pay for with after-tax dollars, are not taxable. However, you might end up paying the IRS and Illinois Department of Revenue after settling certain ERISA claims. If your settlement is taxable, your lump sum could be reduced by more than one-third (depending on your tax bracket).

Before you settle your LTD claim, you should consult with an experienced disability lawyer who can help you understand the tax and financial implications of the proposed buyout.

4. Do You Have a Financial Plan for the Future?

A $300,000 settlement might seem like a financial windfall. However, if you’re unable to work, this amount will quickly disappear as you pay bills, receive medical care, and tend to your family’s needs.

Before you settle your ERISA claim, ask yourself:

  • Do you have other sources of income?
  • Are you receiving Social Security benefits?
  • Do you have a clear understanding of your future medical and long-term care needs?
  • Are you comfortable managing your settlement and following a budget?

If you don’t have good and carefully considered answers to these questions, accepting a lump-sum payment might not be a good idea.

Bryant Legal Group’s Practical Client-Focused Approach to Disability Law

At Bryant Legal Group, our top priority is our clients. That’s why we work closely with them at every step of the way throughout their claim, helping them make informed decisions that benefit them and their families. While we’ve built a reputation for working with professionals with disabilities in and around Chicago, we proudly serve the entire state of Illinois.

To schedule an appointment with one of our skilled and experienced long-term disability attorneys, please either complete this brief online form or call us at (312) 561-3010.

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

Contact Bryant Legal Group

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

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Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

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Chicago Disability Attorney

Insurance companies and their insureds do not interact on a level playing field. The balance of power favors big business. However, when these companies unreasonably deny healthcare claims, they can put you in a precarious and vulnerable position. That’s why insurers owe their policyholders a duty of good faith and fair dealing.

At Bryant Legal Group, we help people when their health insurers deny legitimate claims, improperly delay benefits, or otherwise act in bad faith. In this article, we outline everything you need to know about health insurance bad faith claims.

When Does a Health Insurer Act in Bad Faith?

Under Illinois law, insurance companies cannot unreasonably delay or deny your healthcare claims on “vexatious and unreasonable” grounds. An insurer could be acting in bad faith if they:

  • Deny a valid health insurance claim without a legitimate reason
  • Intentionally misrepresent the facts or the policy’s terms and conditions
  • Fail to communicate with the insured
  • Improperly investigate a claim
  • Refuse to pay part of a claim that it acknowledges is due
  • Deny a valid claim and force litigation
  • Deliberately undervalue a claim or settlement
  • Delay the processing or payment of a clearly valid claim

Admittedly, not every insurance denial involves bad faith. Many insurance disputes involve legitimate disagreements about someone’s eligibility for benefits.  

To determine whether the insurance company is acting unreasonably or vexatiously, insurance lawyers and the courts weigh all the facts surrounding the dispute. Typically, they will consider the sufficiency of the insurer’s investigation and claims process, its behavior during settlement negotiations, statements made by its adjusters and legal counsel, and its conduct towards the insured.

To build your health insurance bad faith claim, it’s best to keep copies of any correspondence between you and the insurer and careful notes from any conversations you have with the adjuster.

Bad Faith Claims Are Unavailable in ERISA Claims

Notably, ERISA, the federal law that governs employer-sponsored benefit plans, does not permit bad faith claims. If your claim involves your employer’s health insurance plan, you might be unable to file a bad faith claim against the company.

However, ERISA does not cover every health plan. Federal, state, and local government employees’ plans are typically exempt from this law. It also does not cover health insurance that you purchase on the marketplace.

RELATED: 5 FAQs About Private Disability Insurance Claims

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What Remedies Are Available in Bad Faith Claims?

In most health insurance claims, you’re demanding coverage, not compensation. However, under §155 of the Illinois Insurance Code, you might be eligible for compensation if a health insurer denies your claim in bad faith. In addition to your health benefits, you could potentially receive either:

  • 60% of your jury award
  • $60,000
  • The difference between your jury award and the insurance company’s settlement offer

Additionally, the insurance company will have to pay your attorney’s fee and case costs.

How Do I File a Bad Faith Claim Against a Health Insurance Company?

In Illinois, you have several options available after a health insurer denies your claim. First, you can file an appeal with the Illinois Department of Insurance. However, the Department of Insurance will not award compensation for a bad faith denial or delays. Instead, it will simply evaluate your eligibility for coverage.

Second, you can file a bad faith lawsuit in a state court. In this claim, you can demand compensation, attorney’s fees, and your case costs under §155. If you file your lawsuit with an Illinois court, you must do so within five years of the denial. 

You should also consider consulting with an experienced lawyer who handles bad faith insurance claims. These cases typically require a detailed legal and factual analysis, and most people cannot adequately represent themselves.

Bryant Legal Group: Trusted Illinois Disability Insurance Lawyers

Bryant Legal Group’s team of respected insurance lawyers handles bad faith claims in Chicago and throughout Illinois. If you believe that your health plan’s delays or denials are vexatious or unreasonable, contact us today for a no-risk consultation. We’ll help you understand your legal options.

To schedule an appointment, please complete our online form or call us at (312) 561-3010.

References
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

Contact Bryant Legal Group

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

Request Your Free Consultation

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

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Chicago Disability Attorney

You’ve filed your application for long-term disability (LTD) benefits, meticulously filling out all the necessary information and submitting all of your relevant medical records. When you get the insurance company’s response, you’re shocked to see a denial of benefits. Unfortunately, the insurance company determined that your disabling conditions were pre-existing.

At Bryant Legal Group, we’re used to insurance companies broadly interpreting our clients’ medical records and incorrectly applying pre-existing condition exclusions. Learn how you can fight back to get the LTD benefits that you deserve.

1. Pre-Existing Conditions Can Be Either Mental or Physical

As a cost-savings mechanism, most long-term disability plans exclude pre-existing conditions. While the definition will vary from plan to plan, pre-existing conditions usually include any chronic physical, mental, or emotional condition that you have been treated for shortly before you obtained coverage. Common pre-existing conditions include cancer, asthma, heart disease, arthritis, depression, and anxiety.

However, many long-term disability pre-existing condition clauses cover more than just a diagnosis. If you saw your doctor and complained of symptoms that were potentially related to a pre-existing condition, the insurer might attempt to deny your claim.

For example, suppose you reported moderate back pain and some numbness in your leg two months before obtaining LTD coverage. Later that year, your doctor referred you to a neurosurgeon who discovered a herniated disc in your lower back. Even though you didn’t have a clear diagnosis at the time you got coverage, the insurance company might deny your claim for disability insurance benefits.

2. Insurance Adjusters Broadly Interpret Pre-Existing Conditions to Deny LTD Claims

Before you apply for long-term disability benefits, you should always review your plan documents and identify potential obstacles. Your policy will include a very specific definition of “pre-existing condition,” as well as other exclusions. If these exclusions apply to your claim, you might be ineligible for LTD benefits.

However, these definitions are always subject to interpretation, so you should never assume that the insurance adjuster was correct in their assessment. Many times, an experienced disability lawyer can help you clarify your condition and avoid your plan’s pre-existing condition exclusion.

Refuting a pre-existing condition exclusion is not a simple process. You’ll need to carefully review the plan documents, identify all of your supporting medical records, and might even need to collect statements from your physicians and other experts.

RELATED: Common Insurer Justifications for the Denial of Private Disability Benefits

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3. Failure to Disclose Your Medical Conditions Can Mean Trouble

When you apply for a private LTD policy, you typically must provide extensive information about your medical conditions and treatment. Then, the insurance company calculates your premiums based on your likelihood of needing benefits in the short term — and may even exclude specific conditions (like cancer) from coverage.

Sometimes, when you apply for LTD benefits, the insurance company will argue that your disabling condition existed at the time you applied, and that you neglected to disclose it.

It’s always in your best interest to fully outline your known pre-existing conditions when you apply for private LTD coverage. However, it’s also understandable that you might not tell the company about that occasional twinge of hip pain that develops into excruciating pain and turns out to be severe degenerative joint disease.

In these situations, you should consult with an experienced disability insurance lawyer.

4. Group LTD Plans Typically Include Pre-Existing Condition Timelines

Group or employer-sponsored LTD plans can’t examine each covered employee’s medical records. Instead, the insurance company places limits on when it will cover a pre-existing condition. Typically, your condition will be excluded if:

  • You reported symptoms or sought medical treatment within a specific period before you obtained coverage (frequently 90 to 180 days).
  • You file for benefits within 12 months of getting LTD coverage.

Therefore, if you’re able to cope with your condition and continue working for more than a year, you might still be eligible for employer-sponsored LTD benefits. However, every LTD plan is different, and your policy could include a different time period or other exclusions.

If you need help interpreting your LTD policy and calculating your exclusion periods, please contact Bryant Legal Group for help.

Discover Bryant Legal Group’s Innovative Approach to Disability Insurance Appeals

Bryant Legal Group is one of Chicago’s most respected disability insurance law firms. We pride ourselves on our practical, client-centered approach and sophisticated legal strategies.

If you or a loved one were recently denied LTD benefits due to a pre-existing condition, it’s time to schedule a consultation with one of our skilled and experienced disability lawyers. We’ll help you understand all of your legal options and suggest meaningful next steps regarding your claim.

You can contact Bryant Legal Group by calling 312-561-3010 or completing this brief online form.

References
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

Contact Bryant Legal Group

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

Request Your Free Consultation

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

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Chicago Disability Attorney

The Hartford is a massive insurance company. Founded more than 200 years ago, it is the second-largest provider of group life and disability insurance in the United States. The insurance company expanded significantly in 2017, when it acquired Aetna’s disability insurance business. In 2018, The Hartford made $19 billion in profits.

At Bryant Legal Group, we help disabled people navigate their short and long-term disability claims with The Hartford. Over the decades, we’ve learned a lot about the company’s tactics.

Keep reading to learn four essential things that every Hartford claimant needs to know.

1. Be Prepared for Surveillance

The Hartford has earned a reputation for its use of surveillance. The company frequently hires private investigators to monitor disabled claimants’ online and real-life activities. If your lifestyle seems inconsistent with your reported limitations and abilities, The Hartford may deny your claim or terminate your benefits.

If you feel like you’re being watched or tracked, you may be right. However, don’t panic if you’re the subject of surveillance. Instead, consult with a lawyer, know your rights, and protect yourself.

For example, investigators cannot enter your property without your permission or record you in your bedroom or bathroom. They also cannot harass or threaten you.

You also should do your best to live within your doctors’ suggested restrictions. For example, if your orthopedic surgeon says you should never lift more than 5 pounds, don’t pick up a 20-pound bag of dog food at the store, even on a good day. First, you may injure yourself. Second, an investigator might be recording your every move.

At Bryant Legal Group, we find that most surveillance footage is relatively benign. It may show you walking to the mailbox or pushing a grocery cart for a few minutes. It rarely shows the price you pay after your brief period of activity or your symptoms during a flare-up. However, you’ll still need evidence, such as medical records, that clarifies the surveillance footage and puts it into perspective.

2. Don’t Expect The Hartford to Investigate Your Disability Claim Properly

This piece of advice applies to every disability insurance company, including The Hartford. You should never rely solely on the company’s representatives to fully investigate and prepare your claim. While you may list all of your physicians and providers in your long-term disability application, the company might not request every single record — and they certainly won’t go out of their way to find evidence that supports your claim.

Instead, you need to compile your medical records, statements from your doctors, and other vital information. This is particularly important in ERISA (Employee Retirement Income Security Act of 1974) claims. In an ERISA or employer-sponsored LTD plan, you only have a limited time to submit evidence.

There are two levels of appeal in an ERISA claim: administrative and federal court. During the administrative (or insurance-level) appeal, you need to build up or “stack” your record with all your supporting evidence — such as your doctors’ notes and opinions.

Once the insurance company closes its case and makes its final decision, you can no longer submit additional evidence. That means that if you wait too long to hire a lawyer or properly develop your claim, it could be too late.

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3. Be Skeptical of The Hartford’s Settlement Strategies

In 2005, a group of workers’ compensation and personal injury claimants filed a class-action lawsuit against The Hartford, alleging that the company intentionally failed to disclose that it would retain 15% of its structured settlement payments. Rather than take the case to trial, the insurance company settled it for $72.5 million in 2010.

While the class-action lawsuit’s allegations were never proven at trial, you should be cautious when accepting a settlement (especially a structured settlement) from The Hartford. Before you agree to a settlement or sign any paperwork, you should always consult with an experienced disability insurance lawyer.

RELATED ARTICLE: When Should I Speak With a Disability Insurance Lawyer?

4. Be Prepared to File an Appeal

The Hartford denies a lot of long-term and short-term disability claims, including cases where people are truly disabled. If you get a denial or termination of benefits letter in the mail, you’re not alone. However, you do need to take immediate action to protect your legal rights. Disability insurance claims have relatively short filing deadlines, and if you miss them, you could lose your right to benefits.

You’ll also want to consult with an experienced disability insurance lawyer at Bryant Legal Group. ERISA appeals are complicated, and you’ll have to follow a series of strict procedural requirements at every step. One missed deadline or clerical mistake can have a profound negative impact on your claim. 

Bryant Legal Group: We’re Prepared to Stand up to The Hartford

Did The Hartford recently deny your disability claim? The skilled lawyers at Bryant Legal Group have handled countless claims against The Hartford and understand their tactics and strategies. To learn more about our approach and how we might be able to help you, please contact us today to receive a free and confidential consultation.

You can reach Bryant Legal Group by calling 312-561-3010 or completing this brief online form.

References
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

Contact Bryant Legal Group

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

Request Your Free Consultation

Get the answers and insight you deserve. Our experienced disability insurance lawyers can evaluate your claim and help you understand all your legal options.

This field is for validation purposes and should be left unchanged.