Getting disability insurance is a smart thing for many employees. A large minority of today’s workers will suffer disabling conditions or injuries at some time during their working careers. When people are unable to return to work for lengthy periods of time or permanently, having the financial protection in place that disability benefits can provide is important. Unfortunately, some disabled workers’ claims are denied by The Standard. The Osterhout Berger Disability Law team is able to help you with your disability claim or appeal of your denial.
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Founded in 1906, The Standard is headquartered in Portland, Oregon. The company employs 3,400 people and covers around 8.5 million people through more than 30,000 employers. The Standard offers disability, accident, critical illness and hospital insurance. It also sells retirement products and annuities.
The Standard offers group and individual short- and long-term disability plans. Group short- and long-term disability plans are offered by employers as a part of their benefits packages. Short-term disability offers weekly benefits when you are disabled and temporarily unable to return to work for up to the maximum duration listed in your policy, which is normally in terms of weeks or months. Long-term coverage offers ongoing benefits payments for much longer periods, which are normally at least several years in duration. Your duration will depend on your policy. The Standard’s individual disability plans can supplement their other products in order to offer more protection for a greater percentage of your income. The company also offers business protection in their disability plans for business owners so that their businesses can continue running when they are disabled.
Short-term disability from The Standard will cover up to 70% of your income with a maximum benefit of $5,000 per week. The longest time you can collect these benefits is for 52 weeks. If your disability is due to an illness or pregnancy, you’ll need to go through a seven day period. If your disability is due to an injury, you won’t have to go through a waiting period. A waiting period is not the same as an Elimination Period. You may still need to go through an Elimination Period before you can start collecting benefits. You can find this information in your policy. Another item you’ll want to look for in your policy is a section specifying exclusions and limitations. Most insurance companies choose to define a disability in different ways. Unfortunately, if an insurance company finds your disability to be a pre-existing condition, your claim won’t get approved. This is why it’s extremely important to read your policy carefully to understand everything that’s included and everything that’s exlcuded.
The Standard’s long-term disability insurance is very similar to its short-term plan, but the maximum benefit you can get is $25,000 per month. The waiting period is anywhere between zero days to two years. Again, you’ll want to make sure to read the policy in its entirety to understand what’s included and what’s excluded as a qualified disability. You’ll also want to see if there are any limitations. If your policy does have limitations and your disability falls under one of these limitations, it doesn’t mean that you won’t receive any benefits. It just means that you may have to comply with a requirement in order to receive the benefit or the benefit may not last as long as if your disability didn’t have a limitation. For example, some insurance companies will place a limitation on disabilities that occured while under the influence. These insurance companies will grant disability benefits as long as the policyholder agrees to attend a rehabilitation program. Read your policy carefully so that you understand if your disability falls under any exclusions or limitations.
The Standard states that it streamlines its claims process. This may benefit some people, but may be detrimental to others if their claim doesn’t fit into the insurance company’s checklist. For this reason, you may experience delays in your claim that are questionable or you may get flat out denied when you really should have gotten approved. If you find yourself in either of these situations, the best thing you can do is reach out to an experienced disability lawyer to help you with your claim so that you can get the benefits you need.
If you’re ready to submit a disability claim to The Standard, you can do so online, by mail, or by fax. If you choose to submit your claim by mail or fax, you’ll need to first download the proper forms. Typically, the forms will require a statement from you, your employer, and your attending physician. There may also be authorization forms that require your signature. Make sure that each and every piece of paper is filled out completely and accurately. Any incomplete information will give the insurance company a reason to readily delay or deny your claim.
If you’ve checked the status of your disability claim online and the status hasn’t updated in a while, you should call the insurance company’s customer service line and ask for an update. If customer service asks you to submit additional paperwork, comply and return the information they’re asking for. If customer service doesn’t provide you with any answers or continues delaying your claim after you’ve complied with their first request, it may be necessary to get in contact with an experienced disability lawyer to help move your claim along.
The Standard will send you a letter if it denies your claim. This letter will contain some important information, so it is important for you to read it. It will list all of the reasons why your claim was denied and explain your right to appeal. The letter will list a deadline within which you must file your appeal. You cannot head straight to court and file a lawsuit. Instead, you are required to go through the company’s internal process and exhaust those appeals before you will be allowed to file a civil complaint against The Standard in court. Don’t miss the deadline for appealing your denial. If you do, your ability to seek your benefits will be foreclosed.
Once you receive your letter, call the company and ask for your claim file to be sent to you. The Standard must provide you with a complete copy upon your request, and your file will contain everything that was gathered during the investigation of your claim. Your experienced lawyer at Osterhout Berger Disability Law will want to review your file and your letter when you come in for your appointment. He or she will then recommend the strategies to use with your appeal.
There are a few things that you should understand about the claim and appeal process so that you can avoid making common mistakes. Don’t stop seeing your doctor even if you think medical care can’t help you anymore. Instead, keep all of your appointments and follow all of the treatment recommendations that you are given. Don’t exaggerate your symptoms to your doctor, The Standard or your attorney. While you might think that this would help your claim, it can instead do the opposite. Insurance investigators look for signs of malingering, and if The Standard believes that you are a malingerer, you will be unlikely to win. To learn more about the claim and appeal process, contact Osterhout Berger Disability Law today.