Washington Denied Disability Insurance Law

Policyholders who have their Washington insurance claim denied for illegitimate reasons may be able to file a denied disability insurance lawsuit or a bad faith insurance lawsuit against their insurer. 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 in the US against companies such as Cigna, Unum and Aetna. A Washington disability insurance attorney can help, regardless of whether an appeal or a lawsuit is being filed.

Policyholders who have their Washington insurance claim denied may either have to file an appeal of the denial or may be able to file a lawsuit.

If the long-term disability policy is part of an employee benefit package—except for cases where the employer is a government entity or religious organization—then the insurance is covered under the Employee Retirement Income Security Act (ERISA). If you have purchased the long-term disability policy yourself or through a broker, then ERISA does not apply.

Denied disability lawsuits and appeals have been filed against large and small insurance companies, alleging those companies wrongfully denied legitimate insurance claims. Policyholders and regulators have been involved in complaints against insurance companies. In 2013, CIGNA agreed to a settlement with five state insurance regulators—including California and Maine—to pay fines and change its claim handling procedure.

If ERISA applies, then you must exhaust the insurance company's appeals process before you can file a lawsuit. Keep in mind that there are important deadlines that must be met. If you do not exhaust the appeals process or if you miss those deadlines, you will not be able to file a lawsuit to appeal the denial.

If ERISA does not apply, 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.

Individuals can file lawsuits against insurance companies to protect their rights and ensure their legitimate claims are properly investigated and approved. In Massachusetts in 2014, a judge ruled AIG operated in bad faith by denying a lawyer's claim following an accident in which he was hit by a bus. The judge found that AIG tried to avoid a settlement with the plaintiff by making up facts about the case and convincing the bus driver to change his story. The judge ordered the lawyer be paid more than $6 million, plus attorney's fees and costs.

In a different case, a woman fought against Aetna Life Insurance Co. in California, alleging the company's denial of her disability claim was wrongful. The court found that Aetna had acted improperly in denying the plaintiff's—Ruth Duarte—claim and ordered Aetna to forward the plaintiff the short-term disability benefits that had been taken away from her and review its denial of her long-term disability claim.

Although these cases were not filed in Washington, many of the laws that apply in California and Massachusetts apply in Washington.

Insurance companies have a duty to carry out a thorough investigation of any claim before denying it. They must behave in a way that is reasonable and meets their contractual obligations to policyholders. If they have unreasonably denied a claim, you have the right to file an appeal of that decision.

Washington policyholders and beneficiaries can get disability denials reversed, through the courts or through an appeals process. Unfortunately, this process can be long and complex. Insurance companies may have the resources to drag out the process even longer or may continue denying the claim hoping the policyholder will give up. Insurance companies such as Unum, Aetna, AIG and CIGNA have all faced claims from policyholders or from state insurance commissioners alleging they improperly handled disability claims.

Washington Denied Disability Legal Help

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Last updated on Jul-30-14