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Appealing a Denial of Disability Benefits from Illinois Mutual

Osterhout Berger Disability Law > Long Term Disability  > Companies > Appealing a Denial of Disability Benefits from Illinois Mutual

Many companies offer disability insurance to their employees by payroll deductions from Illinois Mutual. This type of insurance is designed to offer you financial protection in case you suffer an illness or injury that is disabling and prevents you from working. Some disabled workers are shocked when their disability claims are denied by Illinois Mutual. If this happens to you, the professional disability lawyers at Osterhout Berger Disability Law stand ready to help you with your disability denial appeal with Illinois Mutual.

Background on Illinois Mutual

Founded in 1910, Illinois Mutual is headquartered in Peoria, Illinois. The company offers a variety of insurance products to its customers in 47 states. Illinois Mutual offers life insurance, critical illness insurance, disability insurance, accident insurance and more. The company has around 500 employees and more than 18,000 independent insurance agents.

Disability Insurance from Illinois Mutual

Illinois Mutual offers disability insurance to employers as an optional benefit for workers. The short-term disability insurance offers coverage for several incremental periods following an elimination period of between three and 60 months. Employees who are between ages 17 and 64 are eligible for this type of coverage. Illinois Mutual also offers individual and business owner disability insurance policies in addition to their work site short-term disability policies, which provide coverage for small business owners in case they are disabled so that they can continue paying their bills.

More about short-term disability insurance from Illinois Mutual

Short-term disability insurance through Illinois Mutual will cover up to 60% of your gross salary. This insurance company allows you to collect the benefits on a monthly basis, which is uncommon for short-term disability insurance. In addition to the elimination period, employers may require employees to go through a waiting period, which means that the employees will have to be employed by the company for set amount of days before they become eligible to collect benefits. Usually, this waiting period lasts 90 days, but employers may choose to make it shorter or longer.

Illinois Mutual allows employers to customize policies to an extent, so you’ll want to make sure to read yours thoroughly to ensure you understand what you’re entitled to and how you’re covered. Insurance companies tend to include limitations on the definition of a disability. Certain conditions tend to get bucketed as a disability or as a pre-existing condition. If your injury or illness is considered to be a pre-existing condition, you won’t be eligible to receive benefits under this policy. If you don’t understand the limitations or exclusions found in your policy, you should be able to get in contact with an Illinois Mutual agent to get your questions answered. Understanding your policy can help prepare you when it’s time to submit a claim for benefits.

What you need to know about Illinois Mutual disability claims

It’s extremely important that you fill out your disability claim form completely and accurately when you’re ready to file for your benefits. This should help move the process along smoothly. However, most insurance companies like to drag this process along by requesting more and more paperwork. If information is missing from the claim form, the insurance company may latch onto that and either delay or deny your request for benefits. Don’t give them excuse to easily do that and make sure that you understand how to fill out the claim form.

How to submit a disability claim to Illinois Mutual

If you’re ready to submit a claim to Illinois Mutual, you’ll have to notify the company by calling the claims department. From there, they should send you the forms that you’ll need to fill out and provide instructions on how to get the completely forms back to them. Typically, there are three forms that are required to be filled out: the employee’s statement, the employer’s statement, and the attending physician’s statement. There will probably be authorization forms that will need signatures, so don’t forget those. The trickiest part is getting all parties to fill out the forms and return them to you in a timely manner. However, once you have all of the information and submit the paperwork to the insurance company, it’ll just be a matter of waiting for a response.

What to do if Illinois Mutual delays your disability claim

If you feel as though the insurance company is delaying your claim, you should give your agent a call to check on your claim’s status. This should give you a good idea of how much longer you’ll need to wait, but if you feel as though you’re not getting any answers or the agent is asking for even more paperwork, you may want to consider having an experienced disability lawyer intervene on your behalf. Our disability lawyers at Osterhout Berger Disability Law know how to identify delay tactics that some insurance companies use and can help you move the process along.

What to do if Illinois Mutual denies your disability claim

Illinois Mutual often denies initial disability claims, but you do have the right to appeal if your claim is denied. The company notifies claimants of its denial decisions by mailing them notices in the mail. Your notice will explain why Illinois Mutual denied your claim and how to appeal the decision. Because group-provided work policies are governed by ERISA, you are required to appeal your denial with the company before you can file a lawsuit in court. The appeal instructions will tell you the deadline by which you must file your appeal. If you miss it, you will be barred from trying to recover your benefits in the future. It is important for you to request that Illinois Mutual sends you a complete copy of your claims file because it will include all of the documents and evidence that the company used to support its denial of your claim. If you’re still denied, then you can fight the denial in court. Our lawyers are willing and able to help you through this process.

Appealing a Denial from Illinois Mutual

Our team of experienced attorneys.

Bring both your denial notice and your copy of your file to the experienced disability lawyers at Osterhout Berger Disability Law. Our disability attorneys will review the information in order to determine the best strategy for you to take with your appeal.

When you are working with one of our knowledgeable attorneys, it is important that you are always honest. Some people erroneously believe that they can improve their chances of winning their appeals by exaggerating their symptoms. This can backfire and instead make it much more difficult for you to win because Illinois Mutual may use exaggerations as evidence of malingering. Our experienced lawyers may ask you to assist with your appeal by doing several things. You may be asked to submit to more tests or evaluations. Your attorney may also ask you to obtain statements from your doctor or former employer about the functional limitations that you have suffered because of your disability.

It is important for you to follow through with whatever you are asked to do. The goal of these additional steps is to help you to build as much evidence in your claim file as possible that supports the basis for your claim. By doing this, you may win your appeal while it is still in-house instead of needing to file a lawsuit later. To learn more about how we might be able to help you, contact Osterhout Berger Disability Law to schedule your consultation with our experienced disability team.

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    Learn more about long term disability insurance, as well as appealing denials and how an attorney can help. These five articles will cover the basics: