You’ve been working for years. You’ve paid into multiple insurance policies, including a health policy and a long-term disability policy. Now, due to an illness, traumatic injury or damage from repetitive stress, you’re no longer able to work.
Complete disability can result from a serious illness, like cancer or multiple sclerosis. It could occur after a work or automobile accident. Sometimes, years of working in the same position culminate in a terrible stress injury that prevents you from returning to the same line of work. When that happens, you can file a claim for long-term disability insurance benefits.
Long-term disability claims and benefits should help those who suffer a serious injury or illness maintain a basic standard of living and allow them to access health care and other necessities of life. When someone becomes unable to work, long-term disability insurance can protect that person from poverty and dependence on others.
In the United States, including North Carolina, voluntary pension and health insurance plans, such as long-term disability plans, are governed by ERISA, which sets federal standards to protect policy holders and those who depend on a pension or insurance for income.
What is ERISA and how does it impact your claim?
ERISA is an acronym for The Employee Retirement Income Security Act of 1974, a federal law that created minimum requirements and standards for voluntary insurance policies. Among other functions, ERISA allows for an appeals and grievance process if a policy holder believes he or she had a claim unfairly denied.
In many ways, ERISA benefits workers and policy holders. ERISA requires that plans share information about requirements, funding and other important details that consumers should know. ERISA also offers benefits to insurers, such as allowing for appeals without a jury trial of any kind.
If you believe that your claim for long-term disability benefits which should get governed by ERISA was unfairly denied, you have the right to appeal that decision. Doing so can require an understanding of the insurance appeals process, as well as both state laws and ERISA standards. If you have to deal with appealing a long-term disability denial, you will likely want to confer with a qualified professional about your options before doing so.
You deserve the benefits you’ve paid for over the years
If you’ve spent years paying for insurance premiums, you definitely shouldn’t feel uncomfortable about filing a claim for benefits. Once your doctor diagnoses you with a disability, you will likely need to explore all your options for income and medical expenses. When you are unable to work, the insurance policy you paid into for years should protect you from a total loss of income and benefits.