5 Things You Should Know Before You File a Mutual of Omaha Disability Claim

Jun 9, 2020 | Blog |

Mutual of Omaha is one of the country’s largest disability insurers, offering both short-term and long-term disability policies to employers and individuals. While Mutual of Omaha isn’t as notorious as UNUM or MetLife, the company still has a significant history of improperly denying disability claims.

If you’re about to apply for benefits or file an appeal with Mutual of Omaha, get ready for a fight. In this article, our disability lawyers will introduce you to Mutual of Omaha, explain some of their tactics, and discuss ways you can improve your chances of getting short-term and long-term disability benefits.

Meet the Mutual of Omaha Insurance Company

Mutual of Omaha is a Fortune 500 company that has been selling insurance products since 1909. In addition to long-term and short-term disability insurance policies, the insurer offers life insurance, long-term care, Medicare supplemental plans, and financial services in all 50 states. In 2018, Mutual of Omaha made more than $3.5 billion in income. 

Although the insurance company boasts that it’s been “listening to our customers for more than 100 years,” many people who apply for disability insurance benefits would disagree. A quick online search shows a pattern of bad-faith complaints where the company took advantage of its knowledge and power to deny benefits unfairly.

1. Different Laws May Apply to Your Disability Claim Depending on Whether It Is Employer-Funded or a Private Policy

Many disability claimants don’t realize that different laws apply to different types of disability insurance claims. The laws that apply will frame your entire claim process, including when you can file a lawsuit and how much you can get in damages.

If your Mutual of Omaha policy is an employee benefit, a federal law called ERISA (Employee Retirement Income Security Act of 1974) will likely apply to your claim. Under ERISA, you must follow a strict two-step appeal process.

If Mutual of Omaha denies your application for long-term or short-term disability benefits, you must first “exhaust your administrative remedies” by completing an insurance company level appeal. During this time, you can submit additional evidence that supports your claim.

You cannot file an ERISA lawsuit until the insurance company completes its administrative process and issues a final decision. At that time, you can file a complaint in the federal courts. However, there are limitations:

  • You cannot give the judge any more evidence
  • Jury trials are not an option
  • You cannot demand compensation for a bad-faith denial by Mutual of Omaha

If you’re not sure whether ERISA applies to your disability insurance claim, you should speak with an experienced disability attorney immediately.

However, if you privately purchased your short-term or long-term disability insurance policy or are covered by a “church plan,” state law applies to your claims. If this is the case and you are in Illinois, then you can file a lawsuit as soon as Mutual of Omaha denies your claim; you do not need to make an insurance company-level appeal.

More importantly, in a state law claim, you can:

  • Ask for a jury trial
  • Submit new and material evidence during your lawsuit
  • File bad-faith insurance claims against Mutual of Omaha

RELATED: 5 FAQs About Private Disability Insurance Claims

2. You Need to Carefully Evaluate Your Disability Insurance Plan’s Terms and Conditions

Your eligibility for disability insurance benefits will depend on the terms and conditions in your Plan Document. When you or your employer purchased coverage from Mutual of Omaha, you entered a contract with the insurer. The insurance company only has to pay your benefits if you meet the requirements set out in your agreement.

Your Plan Document and the easier-to-read Summary Plan Description will outline the requirements, which may include specific waiting periods, definitions of disability, appeals procedures, and filing deadlines. If you don’t understand these rules from the very beginning of your claim, you’re at a significant disadvantage, and you may make costly mistakes. When you work with a disability lawyer from our team, we’ll carefully review your Plan Document and help you understand these issues.

3. Be on the Lookout for Delays and Other Unscrupulous Tactics

Insurance companies are for-profit businesses that care more about their shareholders than your welfare. Some insurers even offer their employees bonuses if they deny disability insurance claims. Many companies believe that if they make the application and appeal process difficult, a large number of people will become frustrated and give up.

To try and make you give up, insurance adjusters sometimes use delay tactics that slow your claim to a halt. The adjuster may do nothing for a long time, claiming they are waiting for medical records and other information. Other times, insurance company workers may ignore your phone calls and letters, keeping you in the dark about what’s happening with your claim. Even worse, employees at some companies provide misleading information, hire private investigators to track your every move, and send you to biased medical examiners for so-called “independent” medical examinations.

If you’re getting the runaround from Mutual of Omaha, it’s a good idea to consult an experienced disability insurance lawyer at Bryant Legal Group. We’ve dealt with all of these strategies (and more), and we can help you manage your claim and protect your rights.

RELATED: Can Your Social Media Feed Hurt Your Disability Insurance Claim?

4. Prepare for a Fight and Build Up Your Evidence

Like most insurance companies, Mutual of Omaha denies more short-term and long-term disability claims than it approves. So, you shouldn’t assume that Mutual of Omaha will pay your benefits, even if you have a seemingly strong disability insurance claim.

To give yourself a better chance of getting the benefits you deserve, you should provide compelling evidence to the insurance company, including medical records, detailed letters from your doctors and medical team, functional capacity evaluations, and other data. It’s especially important to provide this information early in an ERISA claim because once your administrative appeal ends, you won’t be able to submit any more evidence.

5. Don’t Take “No” for an Answer Until You Consult a Disability Insurance Lawyer

As we mentioned earlier, insurance companies tend to deny most disability insurance claims, even valid ones. Don’t assume Mutual of Omaha made the right decision when they denied your claim. Often, our attorneys discover that the insurance adjuster made mistakes and misinterpreted the evidence.

As soon as you get a denial of short-term or long-term disability benefits, you should contact Bryant Legal Group if you’re near Chicago, or another respected disability insurance law firm in your area. We can help you understand your legal options and start building your appeal strategy.

Bryant Legal Group: Helping People With Disability Claims Stand Up to Mutual of Omaha

If you have questions about a long-term or short-term disability claim with Mutual of Omaha, the disability lawyers at Bryant Legal Group can help. We’re one of Illinois’ premier disability insurance law firms, and we provide exceptional service and practical advice. To schedule your free consultation with an attorney from our team, call us at 312-561-3010 or use our quick and easy online contact form.

References

Deloitte. (2018). Statutory Financial Statements as of and for the Years Ended December 31, 2018 and 2017, Supplemental Schedules as of and for the Year Ended December 31, 2018, and Independent Auditors’ Reports. Omaha, NE: Mutual of Omaha. Retrieved from https://cdn.mutualofomaha.com/documents/mutualofomaha/pdf/mutual-sap-2018-report.pdf?_ga=2.193367085.1000631428.1589227957-601081206.1576183920

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

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