Individual Disability Insurance Claims
Individual disability insurance can be ideal for anyone who does not receive disability insurance through a group plan at work. It is also an option for high earners looking for extra coverage. It is possible to participate in a group disability plan at work and have an individual policy and make a claim under both policies arising from the same disability.
Group disability coverage is tied to a person’s employment. If a person changes or loses their job, the coverage is not portable. Individual policies offer more flexibility. Once issued, the language, benefits, and costs of an individual disability policy are contractually guaranteed, even if a person changes their occupation or employment.
Individual policies pay a fixed benefit amount each month which is different than group disability coverage which is tied to a person’s W-2 income or base salary.
Individual policies are usually issued as non-cancelable and guaranteed renewable, which means the insurance company cannot modify the policy once it is issued. Policies may also allow for a gradual return to work, where an employee starts out part-time and continues to receive a partial benefit, or if a person cannot perform the duties of their own occupation, allows them to work in another occupation and still collect full benefits. For example, The Law Offices of Kevin M. Zietz has represented physicians who became unable to work full-time in their area of medical specialty due to their medical condition, yet they were able to receive their full monthly disability benefit while working in a different capacity in the medical field (i.e., seeing patients in the office (as opposed to performing surgery), teaching, medical-legal work, etc.).
If a claim is denied under an individual disability policy, there is a broader range of legal remedies that are available because the claim is governed by state law and not ERISA. It is important that a person with a denied individual disability claim speak with an attorney about their options, and also about the time limitations that apply to the causes of action that can be pursued if it becomes necessary to file a lawsuit against the insurance company. The Law Offices of Kevin M. Zietz offers a free consultation to review the options available when an individual disability claim has been denied.
