In addition to reading “Recover Your Benefits: Keys to Successfully Navigating the Disability or Life Insurance Appeal Process,” we recommend that every single person with an insurance company denial letter also contact an experienced attorney for a free case review.
The most frequent reason people give for not talking with an attorney about their disability or life insurance denial is that they “know their claim is too small.” Maybe their claim is for a few weeks or months of Short-Term Disability (STD) only and they’ve returned to work already. Or maybe they were approved for Social Security Disability Income (SSDI), and after the insurance company deducts that from their Long-Term Disability (LTD) benefit, the resulting monthly benefit payment is just a few hundred dollars, or less. Maybe it’s just not clear whether the claim will continue, or whether a treating doctor will help with the appeal.
It’s true that most “small” cases like this are not going to be a good fit for attorney representation. But it makes sense to go through the (free!) case evaluation anyway, for two main reasons:
- You could be wrong. You just never know what an experienced attorney will see in your case. And unless you ask them to take a look, they’ll never get the chance to tell you.
- Knowledge is power. It’s always helpful to know whether contingent fee representation is an option for you. And even if you turn out to be right and it’s not, understanding why your case is not a good fit for an attorney at the appeal stage can be important information.
It can also help to understand that when an attorney tells you they cannot represent you for your appeal, it often has absolutely nothing to do with the merits of your case. Every case is different, but often people are surprised to find that they are not able to hire an attorney for their appeal even if they want to. They may take that as a sign that their claim is not worth appealing, which can be far from accurate. Most, if not all, attorneys who handle insurance cases do so on a contingent-fee basis. That means they only get paid if they recover money for you, either as the result of an appeal or after filing a lawsuit if your appeal is denied. You pay them nothing up front. When they do recover money for you, you pay them a percentage of the recovery from the insurance company. This often includes both the back benefits the insurance company owes you, and (for disability claims) future benefits for a period of time, up to the entire length of your claim. The exact terms vary depending on the firm and the case, but a fee of around one-third of your benefits is common.
Insurance companies are rarely predictable. There’s just no such thing as a “slam dunk” appeal. With every case, no matter how strong the evidence is, the attorney is looking ahead to the resources they will need to invest if your appeal is denied and they have to file a lawsuit. They weigh that against their potential fee in the case. If they decide your case falls outside their parameters, the attorney will tell you they are unable to represent you for the appeal.
While it’s helpful to know all the options that are available to you, keep in mind that the only person who makes the decision about whether to appeal or not is you. Even if your case may be too uncertain or your benefit amount too low for contingent fee representation, your appeal can still be winnable with the right preparation. You may receive only the policy’s minimum benefit amount, but for most people, everything helps when you’re facing a disability.
So do make sure that one of your first calls is to an experienced attorney. If you don’t have one already, please contact us and we can recommend someone from our Resource Network.
