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Appealing a Denial of Disability Benefits from Principal Financial Group

Osterhout Berger Daley > Insurance Companies > Appealing a Denial of Disability Benefits from Principal Financial Group

If your employer offers disability insurance through Principal Financial Group as a part of its benefits package, it may be a good idea for you to choose this coverage. Disability insurance can help you if you are ever temporarily or permanently disabled and unable to return to work by replacing a percentage of your former income for the duration specified in your policy. If you are disabled and submit a claim, you may feel overwhelmed if Principal Financial Group decides to deny your claim. If that happens to you, the professional disability lawyers at Osterhout Berger Daley might represent you on your appeal.

Background on Principal Financial Group

Founded in 1879, Principal Financial Group is on the Fortune 500 list and is publicly traded on the New York Stock Exchange. It is a global insurer that is based in Des Moines, Iowa, and it has more than 14,600 employees. In addition to a broad range of insurance products, the company also offers retirement benefits and investment products for its customers around the world.

Disability insurance from Principal Financial Group

Principal Financial Group offers short- and long-term disability group insurance coverage through employers as well as supplemental individual disability insurance plans. The group plans offer benefits that are payable for the duration of your policy if you are disabled and unable to return to work for a short period or a longer time, depending on whether or not you have short-term disability insurance, long-term disability insurance or both. The individual disability plans are portable, meaning that you can take them with you if you leave your job and move on to another as long as you continue making your premium payments.

Principal Financial Group short-term disability insurance

Short-term disability insurance through Principal Financial Group is customizable, which means the exact policy will depend upon your employer’s choices for the company. However, the structure of the policy will be the same across the board. Each policy will have the following:

  • A set benefit percentage: Your employer can set the benefit percentage to be anywhere between 50%-66⅔% or choose another option entirely.
  • A maximum weekly benefit: Principal Financial Group sets the traditional maximum weekly benefit to a maximum of $2,500. If your employer chooses a voluntary plan, the maximum could be $1,500.
  • A benefit duration: This could be 13 or 26 weeks. Your employer could also choose another option entirely.
  • An elimination period: Your employer can choose 1st day accident/8th day sickness, 8th day accident/8th day sickness, 15th day accident/15th day sickness, or 30th day accident/30th day sickness. These options are shorter than most elimination periods at other insurance companies, which can be anywhere from 60-90 days.

When it comes to defining a disability, Principal Financial Group provides two criteria for the definition. Policyholders must fit one or the other. If a policyholder is “unable to perform the majority of substantial duties of their own job”, they will be considered disabled. If a policyholder is “unable to earn 80% of their pre-disability income while working in a modified capacity”, they will also be considered disabled. It’s important to understand why this insurance company looks at the policyholder’s own job when considering whether or not they’re truly disabled. The insurance company explains, “[This] means we look at the job the employee was performing on the date of the disability – not the occupation.” When it comes to long-term disability, the insurance company will then look at the policyholder’s own occupation when considering the definition of a disability.

Be sure that you also read your policy carefully to ensure that the insurance company doesn’t define “disability” further by considering some conditions to be pre-existing. If the insurance company does consider certain conditions to be pre-existing, you won’t qualify for benefits.

Principal Financial Group long-term disability insurance

The structure of Principal Financial Group’s long-term disability insurance is similar to its short-term plan, but there are a few differences.

  • Benefit percentage: 50-60% or an entirely different option agreed upon between your employer and the insurance company.
  • Maximum monthly benefit: up to $15,000 for a traditional plan or up to $10,000 for a voluntary plan.
  • Benefit duration: Until you’re of the Social Security Normal Retirement Age (SSNRA), 2 years, 5 years, or to age 65.
  • Elimination period: 180 days or 90-365 days

One feature that is different from the short-term disability plan is the own occupation period. This becomes important when you consider Principal Financial Group’s definition of a disability. While the insurance company looks at the employee’s “own job” in the definition for short-term disability, the insurance company looks at the employee’s “own occupation” when it comes to long-term disability. So, the definition of a disability is amended to be when the policyholder is “unable to perform the majority of substantial duties of their own occupation”. The insurance company then imposes an additional period called “Own occupation period”. According to the insurance company, “the period of time employees are considered disabled and unable to perform their own occupations is called the own occupation period. Once the own occupation period has ended, they’re considered disabled if they’re unable to perform any occupation.”

Be sure to read your policy carefully and ask your employer questions if you don’t understand something.

What you need to know about Principal Financial Group’s disability claims

It’s not uncommon for disability claims to be denied. Principal Financial Group is not excluded from the list of insurance companies that deny or delay disability claims. The good news is that you can fight back. However, before you ever find yourself in the position of needing to fight back, it’s important that you understand how to submit a disability claim accurately and completely.

How to submit a disability claim to Principal Financial Group

You can either submit a disability claim online or by mailing the completed form into the insurance company. The claim form will require you, your employer, and your attending physician to fill in the necessary information. It’s extremely important that you make sure that your employer and attending physician complete each other sections accurately. Any inaccuracies or incomplete sections may result in the delay or denial of your claim. There will also be an authorization that will require your signature. Don’t forget to complete that part of the form. Once you’ve submitted the form, you’ll have to wait to hear back from the insurance company.

What to do if Principal Financial Group delays your disability claim

If you haven’t heard back from the insurance company in over ten days, you should contact the insurance company to check on the status of your claim. If they provide you with little to no information or ask you for more information to submit, they may be intentionally delaying your claim. If this is the case, you may want to turn to an experienced disability lawyer to help get your claim through the rest of the process. Our experienced lawyers at Osterhout Berger Daley can help you determine whether or not your claim is being intentionally delayed and can help move your claim through the rest of the process.

What to do if Principal Financial Group denies your disability claim

If your claim is denied, Principal Financial Group will send you a letter notifying you of its decision. This letter will tell you the reasons that the company used to deny your claim and explain the process for appealing the decision. There will be a deadline that is listed in your letter for filing your appeal. You must appeal before the deadline passes, or you will not be able to ever recover your benefits from Principal Financial Group. When you receive a denial letter, it is important for you to act quickly. You can set up an appointment with the experienced disability lawyers at Osterhout Berger Daley.

Our team of experienced attorneys.

Appealing a denial from Principal Financial Group

In addition to contacting an experienced disability lawyer, you should also call Principal Financial Group and request that the company sends you a copy of your claim file. when you receive it, bring it with you to your appointment. The file will have everything that the company used against you when it denied your claim. By reviewing it, your experienced lawyer will be better able to design the most strategic approach for your appeal.

You should always be honest about your symptoms and resist the urge to exaggerate them. Trying to act like your condition is worse than it really is may make the company decide that you are malingering. This is considered to be strong evidence that undercuts the validity of your claim. Your experienced attorney might want you to help with your appeal by keeping all of your medical appointments and submitting to additional tests and exams. Make sure to follow through with everything because they are meant to help you to build a stronger case on appeal. If you can add as much favorable evidence supporting your claim to your file as possible, you may win your appeal within the company’s internal process without needing to file a lawsuit. Contact Osterhout Berger Daley today to schedule your consultation.