Short-term and long-term disability plans are supposed to provide workers and professionals with coverage to make ends meet when a serious medical impairment or injury takes the person away from work. Not everybody participates in these insurance plans. In fact, the Bureau of Labor Statistics says the roughly 39 percent of people working in private industry 2014 had short-term disability (STD) coverage and 33 percent carries long-term disability (LTD) coverage. Of those in management and professional positions the participation rate was significantly higher.

LTD Insurance Claim Disputes Lead The Pack In Employee Benefits Litigation

Unfortunately, research indicates that obtaining the benefits due under a disability insurance policy when a problem arises is not as easy as it should be — even with a valid claim. A law lecturer in Illinois who is well-respected for his knowledge of employee benefits issues looked into employee benefits litigation across the spectrum of types of claims — health care claims, pension disputes, life insurance and accidental death claims, as well as LTD coverage litigation.

While disability insurance participation rates are generally far lower than the other forms of employee benefits programs, the research (published in the ABA Journal of Labor & Employment Law) shows that 60 percent of employee benefits lawsuits filed in federal court between 2006 and 2010 involved LTD insurance disputes. The insurance companies have a great deal of power in handling claims.

The Insurance Providers May Deny A Claim, But Is That The End Of The Story?

Many of the legal challenges in the research involved unfair denials of claims. The lead researcher says that because the insurance companies take care of administering the employee benefits plan, have the power to decide whether or not to deny the claim and, if the business decides to pay benefits under the policy, it is the insurance company that has to pay. Do the math. The insurance providers likely do. The odds are stacked against granting benefits under the insurance policy with the system as it is – providing the administrator and provider with the power of choice.

It is critical for professionals and other workers who are relying on an insurance policy to know that a denial is not always the end of the story. At the first sign of delay or other trouble in obtaining benefits it may be a good idea to speak with an experienced Illinois lawyer who is well-versed in short-term and long-term disability insurance issues to protect your rights.

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