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Appealing a Denial of Disability Benefits from Guardian

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

Founded in 1860 and headquartered in New York City, Guardian Life Insurance Company has around 8,000 employees in the U.S. It is on the Fortune 500 list and is ranked at 254. It offers a broad menu of insurance products and services, including life, dental, vision and disability insurance as well as annuities and investments.

Types of disability insurance from Guardian Life Insurance Company

Guardian Life Insurance Company offers several different types of disability insurance. The company offers Individual Disability Insurance, which is similar to long-term disability insurance that offers you monthly benefits that replace a portion of your base salary, bonuses and incentives income when you are sick and no longer able to return to your job. It also offers basic disability coverage that is provided to employees by employers. This coverage typically protects from 40 percent to 60 percent of the before-tax base income.

Supplemental Individual Disability Insurance is an option to employees for whom their employers offer the basic disability coverage. It provides a greater percentage of the base pay, bonuses and salary that the employees received prior to becoming disabled. Finally, the Guardian Life Insurance Company offers business protection disability insurance coverage, which is a type of insurance that small business owners can choose to protect themselves if they become disabled so that their businesses can continue running as long as they are unable to return to their companies.

Individual Disability Insurance

Similar to long-term disability insurance, Guardian Life Insurance Company’s Individual Disability Insurance will replace a percentage of your income in the event you become disabled. However, this type of disability insurance can also supplement the long-term disability insurance that you may have through your employer. Unlike disability insurance offered by your company, the Guardian’s Individual Disability Insurance belongs to you. So even if you decide to move on to another company, this insurance plan moves with you.

Group Disability Insurance

This is basic disability insurance offered by your employer. It covers anywhere between 40-60% of your income in the event you become too sick or injured to work. You’ll want to make sure that you read this policy carefully to understand what is defined as a disability. Some insurance companies will leave out certain conditions from being defined as a disability and will not cover these ailments. It’s important to read the policy carefully so that you understand what your entitled to under this type of disability insurance.

Supplemental Individual Disability Income Insurance

This supplemental disability insurance is also offered through your employer. This disability insurance is in addition to the Group Disability Insurance your employer offers through the Guardian Life Insurance Company. This insurance also allows you to protect any bonuses and commissions you would normally get through your employer in addition to your income. Unlike the Group Disability Insurance, the Supplemental Individual Disability Income Insurance will follow you to your next job should you choose to switch companies. Another benefit of this insurance is that a medical exam isn’t required.

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What you need to know about claims through the Guardian Life Insurance Company

Understanding how to completely and accurately fill out a disability claim is extremely important to ensure that you get your benefits approved. Insurance companies will try to find the smallest inaccuracies to delay or deny your claim. The Guardian Life Insurance Company is no exception. Pay attention to each section of the claim forms and make sure that everything is filled out properly. If you’re unsure about the information you, your employer, or attending physician provided, seek help. Our lawyers at Osterhout Berger Daley are willing and able to help you through this process.

How do I submit a claim to the Guardian Life Insurance Company?

For the most part, submitting a claim for short-term disability and submitting a claim for long-term disability are going to have the same process. The forms will both require your statement of the disability, your employer’s statement and your attending physician’s statement. You may be asked to sign other authorization forms, especially if you’re filing a claim for long-term disability insurance.

Once your form is completely and accurately filled out, you can submit your claim by mail or online. The instructions on how to submit a claim online should be found on your form. Guardian states that once the insurance company receives your claim, you and your employer will get a formal acknowledgement letter. This letter will notify you that your claim was successfully delivered to the insurance company. If you don’t receive this letter, follow up with the insurance company until you’re provided with proof of delivery.

What do I do if the Guardian Life Insurance Company delays my claim?

If you believe that your claim is being delayed, you’ll want to reach out to the insurance company to check on its status. The delay may be a result of additional paperwork that the insurance company may need you to fill out. However, if you’re being given the runaround and not getting any real answers, it may be time for you to seek help from a lawyer. An experienced disability lawyer will be able to identify the Guardian’s delay tactics and help move the process along so that you don’t have to wait any longer to receive your benefits.

What do I do if the Guardian Life Insurance Company denies my claim?

It can be discouraging to receive a notice of denial of your disability claim from the Guardian Life Insurance Company. Unfortunately, the company denies many claims when they are submitted. If you receive a denial notice, take the time to review it carefully. The company must tell you the reasons it is using to deny your claim. Your letter will also tell you that you have the right to appeal, and it will tell you the process for doing so and the deadline for filing your appeal. You must exhaust Guardian Life’s own internal remedies before you will be allowed to file a lawsuit in court. If you miss the deadline of appeal, you will be prevented from later trying to recover the benefits from the company for your disabling condition.

Appealing a denial from the Guardian Life Insurance Company

The experienced lawyers at Osterhout Berger Daley have extensive experience with handling appeals of denials from Guardian Life Insurance Company. When you get your denial notice, request a copy of your file from the company, and bring both your letter and your file into our office. Your knowledgeable lawyer will review your documents and provide you with an honest assessment of the next steps that you should take. Your lawyer might ask you to get additional tests from your doctor or another medical professional. He or she may also want you to get written statements from your employer, family and doctor about how your disability limits your daily functioning at your job and in your tasks of daily living. This is important because it helps to supplement the information that is contained in your claim file. By adding favorable evidence that supports your claim for disability benefits, you are likelier to succeed on your internal appeals. If you exhaust the internal remedies, you will also be limited to the evidence that is contained in the company’s file if you later file a lawsuit. By building your file favorably, your attorney may help you to have a greater chance of succeeding on your appeal.

To learn more about how we can help, contact the experienced disability lawyers at Osterhout Berger Daley today.

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