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Appealing a Denial of Disability Benefits from Boston Mutual

Osterhout Berger Daley > Insurance Companies > Appealing a Denial of Disability Benefits from Boston Mutual

A large percentage of today’s young workers will suffer from disabling conditions or injuries at some time during their working years. In order to protect yourself in the event that you become disabled, you may have purchased disability insurance from Boston Mutual Life Insurance. Your employer may also provide this type of insurance as an employer-paid benefit on your behalf. Workers who are disabled and who have this coverage may receive payments to replace part of their incomes while they are unable to work. Unfortunately, Boston Mutual Life Insurance Company often denies disability claims. If your claim is denied, it is important that you seek help from the experienced legal team at Osterhout Berger Daley.

Background on Boston Mutual

Headquartered in Canton, Massachusetts, Boston Mutual Life Insurance Company was founded in 1891. The company has 320 employees and sells a variety of different insurance products, including life insurance, disability insurance, critical illness insurance and accident insurance.

Disability insurance from Boston Mutual

Boston Mutual offers several different disability insurance products through workplaces. They offer several types of employee-paid short-term disability insurance for private and public sector workers. The premiums are deducted from the employees’ paychecks. Short-term disability pays benefits for a limited duration after the employees have been out of work for longer than the specified elimination periods. The company also sells both employer-paid and employee-paid long term disability benefits. These benefits pay a percentage of your former income for longer durations. The durations are variable and will depend on the provisions contained in your policy.

Boston Mutual short-term disability insurance

Boston Mutual’s short-term disability insurance policies have flexible options that allow your employer to design the plan as they see fit. So certain aspects of your policy will depend on your employer’s preferences. However, every policy will be structured similarly. This includes:

  • An elimination period that you’ll have to go through before you can start receiving your benefits
  • A percentage of your income will be paid out to you weekly
  • The duration of your benefits will last up to 52 weeks

There may be features that your employer chooses to add such as a waiting period where you’ll have to be employed with the company for a set amount days before you can opt into short-term disability insurance. You’ll also want to read your policy carefully to determine what Boston Mutual and your employer deem to be a disability. For example, your employer may or may not choose to define maternity as a disability. Understanding your policy will help prevent running into issues down the road.

Boston Mutual long-term disability insurance

Long-term disability insurance from Boston Mutual is very similar to its short-term policy, the benefits duration and elimination period last longer. Your benefits may also be paid out monthly rather than weekly. Ultimately, the insurance company still allows employers to design policies to fit their needs, so read your policy carefully to understand what you’re entitled to in the event you find yourself with a disability.

Our team of experienced attorneys.

What you need to know about Boston Mutual claims

It’s very important to remember that insurance companies are businesses. It’s in the company’s’ best interest not to pay out benefits. Boston Mutual is no exception. While this insurance company doesn’t deny or delay every claim that comes its way, it has been known to unfairly delay or deny claims. To prevent this from happening, it’s important to fully understand your policy and understand how to fill out the disability claim forms completely and accurately.

How do I submit a disability claim to Boston Mutual?

Boston Mutual has forms for short and a long-term disability that you will need to submit. Both forms require the same information: employer’s statement, employee’s statement, authorizations to obtain information, and your attending physician’s statement. The claim forms will need to be sent to two different places depending on the type of disability insurance you have. The addresses can be found in the disability claim kit.

What do I do if Boston Mutual delays my disability claim?

If you haven’t received a letter from Boston Mutual approving or denying your claim after submitting the appropriate forms, you may want to call the insurance company’s customer service line at 877-212-2950 to speak to a Claims Representative. This representative should be able to give you the status of your claim. If they don’t provide with you any helpful information, you may want to ask your employer to reach out to the insurance company on your behalf to check the status. If you’ve exhausted both of those options and still don’t hear back from the insurance company, you may want to seek help from an experienced disability lawyer. Our lawyers at Osterhout Berger Daley have experience dealing with insurance companies that delay claims and can help resume the process.

What do I do if Boston Mutual denies my claim?

Boston Mutual notifies claimants of its denial by mailing denial notices to their home addresses. If you receive a denial letter, it is important that you take the time to review it carefully. Your letter will tell you why the company denied your claim, and it will give instructions for how you can appeal its decision. There will be a deadline in your letter for filing your appeal. It is important that you adhere to the deadline because if you miss it, you will not be able to try to recover your benefits later. Under the law, you must complete the company’s internal appeals process before you will be allowed to file a lawsuit against Boston Mutual in court.

Appealing a Denial From Boston Mutual

After receiving your letter, contact the insurance company and ask for a copy of your file. The company must provide it to you upon your request. Bring the letter and your file to the experienced attorneys at Osterhout Berger Daley. The lawyers will review the documents and determine the best strategy to take. Your lawyer may expect you to help with your appeal by doing certain things. It is important that you follow through with the various tasks so that your appeal case will be stronger.

You might expect to be asked to submit to more medical exams and tests. Your lawyer might also want you to get written opinions from your doctor, your former employer and your family members about the functional limitations that your condition causes for you. Doing these extra things helps your claim by building more evidence that is favorable to your claim. If you exhaust your appeals with Boston Mutual, you will only be able to use the evidence in your file. It makes sense that you make certain to add as much favorable evidence as possible. The knowledgeable attorneys at Osterhout Berger Daley have a record of success with winning their clients’ appeals within the company’s internal appeals process. To learn more about your claim, contact us today to schedule your consultation.

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    Learn more about long term disability insurance, as well as appealing denials and how an attorney can help. These five articles will cover the basics: