Oregon Denied Disability Insurance Law

Policyholders who have their Oregon insurance claim denied for wrongful reasons may be able to file a denied disability lawsuit or a breach of insurance contract claim against their insurance company. Depending on the circumstances of their insurance, they may either have to file an appeal or they may be able to file a lawsuit right away. Lawsuits and appeals have been filed against insurers across the USAn Oregon disability insurance attorney can help, regardless of whether an appeal or a lawsuit is being filed.

Whether you or are able to file a lawsuit right away or file an appeal depends on the laws governing your insurance.

If the long-term disability policy is provided by your employer—except in cases where you employer is a government entity or religious organization—then your insurance is covered by the Employee Retirement Income Security Act (ERISA). If you have purchased the long-term disability policy through a broker (that is, it is not provided by an employer) then ERISA does not apply.

If your insurance is covered by ERISA, then you must complete the insurance company's appeals process prior to filing a lawsuit. It is important to note that there are important deadlines that must be met when filing your appeal. If you do not first go through the appeals process or if you miss the appeals deadlines, you will not be able to file a lawsuit against your insurance company.

If your insurance is not covered by ERISA, you may be eligible to file a lawsuit as soon as your insurance claim is denied. It is important to check, however, to make sure that you are not required to appeal through the insurance company first. Your contract, plus your state's statute of limitations, set out how long you have to file an appeal or to file a lawsuit.

Lawsuits have been filed by policyholders and regulators, alleging insurance companies wrongfully deny legitimate claims, putting policyholders at risk of either having to pay out-of-pocket for treatment or not seeking necessary treatment at all. Among companies that have faced such lawsuits are Aetna, CIGNA, Unum and AIG.

In 2013, five states including California, Connecticut and Maine reached a settlement with CIGNA to resolve complaints regarding the company's claims handling practices. An investigation by officials reportedly found that CIGNA had claims-handling irregularities, including not giving proper weight to the findings of independent physicans. As part of the settlement, CIGNA will reevaulate certain claims and will pay a fine.

Individual policyholders have also filed their own lawsuits to protect their rights. In one case, a judge in Massachusetts found that AIG acted improperly by making up false evidence and suppressing evidence that would have helped the plaintiff's claim in a lawsuit against the company. In that case, AIG allegedly attempted to avoid a settlement with a lawyer who was hit by a bus. The judge found that the conduct of lawyers for AIG was either known to the company or was easily discoverable. Ultimately, the judge awarded the lawyer more than $6 million, plus attorney's fees.

Insurance companies have a duty to carry out a thorough investigation of any claim before denying it and to honor their contracts. If they have unreasonably denied a claim, you have the right to file an appeal of that decision.

When insurance companies fail to honor their contracts, policyholders can file a lawsuit or an appeal to protect their rights. Lawsuits and appeals have been filed across the US against large and small insurers such as Unum, AIG and CIGNA, by policyholders who felt their insurance claims were improperly denied.

Oregon Denied Disability Legal Help

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Last updated on Jul-30-14