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Private/Individual Disability Claims and Appeals

Osterhout Berger Daley > Practice Areas > Private/Individual Disability Claims and Appeals

Understanding Private Disability Plans

Many Long Term and Short Term Disability plans are employer provided and governed by ERISA. However, other plans are privately or individually purchased and do not fall under ERISA’s constraints.


Navigating the Application and Appeals Process

If you have privately or individually purchased disability plan, the application and appeals process will be detailed in your plan. The process can vary between plans and often includes multiple appeal levels. It is crucial to have a skilled attorney by your side to ensure you comply with all the requirements under your plan and help build the strongest case for you.


Legal Options after Claim Denial

If your claim is ultimately denied under the carrier’s internal appeals process, you may file a lawsuit typically for breach of contract and/or bad faith. We will work with you to prove the carrier breached their contract and violated the insurance policy by failing to acknowledge your disability and award benefits in accordance with the policy’s terms. In bad faith claims, we will collaborate with you to prove the insurance company breached the covenant of good faith and fair dealing when they denied your claim.


Frequently Asked Questions


What is the difference between a privately purchased disability plan and an employer-based plan?

Privately purchased disability plans are not governed by ERISA and may have different application and appeals processes than employer-based plans.


What can I do if my private/individual disability claim is denied?

If your claim is denied, you can appeal the decision following the appeals process outlined in your plan. If the claim is ultimately denied after exhausting all appeals, you may file a lawsuit for breach of contract and/or bad faith.


How can an attorney help me with my private/individual disability claim?

An experienced attorney can help you comply with your plan’s requirements, build a strong case for your claim, guide you through the appeals process, and represent you in a lawsuit if necessary.


Contact Osterhout Berger Disability Law Today

Don’t face the challenges of private/individual disability claims and appeals alone. Allow the experienced attorneys at our law firm to guide you through every step, ensuring the best possible outcome. Contact us today for a free consultation and let us fight for the disability benefits you deserve. Call 866-438-8773 or fill out our online contact form to begin securing the financial support you need.

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