BRYANT LEGAL GROUP
Group Insurance Disability
In Illinois, and elsewhere, group long-term disability insurance benefits — provided through an employer-sponsored disability plan — are quite common, though many insureds do not understand the rights they are granted under such coverage and how that may affect their ability to challenge a claim denial.
If you have had your group insurance disability claim denied, you may be entitled to challenge the decision of your insurer and obtain your rightful benefits. Contact Bryant Legal Group, P.C. today to connect to an experienced Chicago group insurance disability attorney for further information on how to proceed with your dispute.
I can’t thank David and Jennifer enough for going the extra mile to get Guardian to pay my claim, regardless of the fact that my type of claim, although very legitimate, was difficult to gain coverage. They are my heroes for not giving up. I’m very thankful for both of them and their staff.
ERISA Basics
The Employee Retirement Income Security Act (ERISA) was created with the intention of protecting plan participants against the abuses of insurers and plan administrators responsible for handling employer-sponsored insurance benefits plans. ERISA is a federal regulatory scheme that applies to the claims of those whose disability benefits are provided through a qualified plan.
If you have purchased disability benefits through an individual disability plan, for example, then your claims would be governed by state law, not federal ERISA regulation.
Not all group plans are covered by ERISA — though most are. ERISA-governed plans are those that concern employee welfare benefits (i.e., disability, health insurance, etc.) and are sponsored or established by the employer. It should be noted, however, that ERISA does not apply to benefits plans sponsored or established by public employers or religious organizations.
ERISA regulation implements various limitations on insureds, unfortunately. These include a restriction on the ability to bring bad faith claims against the insurer or plan administrator, and a requirement that the insured exhaust all administrative remedies before pursuing a civil action against the insurer or plan administrator.
Given the unique complexities associated with ERISA-governed plans and disputes arising from such coverage, it’s important to consult with an experienced attorney who understands ERISA regulation and qualifying plans.
Offsets Are Common
Group disability plans commonly include “offsets” designed to limit the insurer’s obligation to pay the full disability benefit due when the insured is receiving or is entitled to benefits through other, collateral sources, such as workers’ compensation or Social Security Disability.
For example, if you are entitled to disability benefits of $3,000 per month through your group disability coverage, but are also receiving workers’ compensation (wage loss) benefits of $1,500 per month due to the same disabling condition, then you may have to report the receipt of workers’ compensation benefits to the disability insurance provider — the disability benefits amount will be offset by those collateral workers’ compensation benefits, thus ensuring that your total does not exceed $3,000 per month
Consult an Experienced Chicago Group Insurance Disability Lawyer for Assistance
Here at Bryant Legal Group, P.C., our attorneys have decades of experience handling disability claims and disputes on behalf of insureds. We are a results-oriented firm, willing and able to go toe-to-toe with large insurance carriers. Over the years, we have litigated numerous actions against disability insurers, and have a long and consistent track record of success in obtaining benefits (and other damages) for our clients.
We understand that those who have had their claims denied or otherwise mishandled by their insurer — whether in a group plan or an individual plan — may be feeling overwhelmed by their situation and by the vulnerable position they find themselves in.
At Bryant Legal Group, P.C., we work closely with clients to ensure that they are kept apprised of case developments and that they fully understand how the dispute will proceed. It’s important to us that you know what is happening, so that you are emotionally equipped to handle the challenges that have been laid at your feet.
Call (312) 634-6415 to speak to an experienced Chicago group insurance disability lawyer at our firm for guidance.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
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