Internal Appeal Process of the LTD Insurer is Not the Only Option

Internal Appeal Process of the LTD Insurer is Not the Only Option

If long-term disability (“LTD”) benefits are denied, the insured has two different options to pursue LTD benefits further. One is an external appeal: it involves filing a civil lawsuit against the LTD insurer. It is called “external” because the procedure and decision-maker are independent of the parties, the insurer and insured. The procedure is that which applies in any other civil proceeding, and the decisionmaker is a civil court judge. The deadline for an external appeal is generally two years from the date the claim was denied. Another is an internal appeal: it involves asking the insurance company to reconsider its decision. It is called “internal” because the procedure is determined by the insurance company and the decision-maker is partial since they are an employee who works for the insurer. The deadline for an internal appeal is usually set out in the insurer’s denial letter. Is an internal review really worth it? Many lawyers believe that it is not; here is a rhetorical question that explains the reason – Why would an insurer who denied your claim in the first instance, grant it in the second? An internal appeal is essentially asking the insurance company to review its own decision. On the contrary, most LTD lawyers would recommend taking legal action instead of appealing. If you were denied LTD benefits, the best thing you can do is to contact an experienced LTD benefits lawyer who can fully advise you of your rights and remedies. Usually, if a LTD claim is denied, it is because there was a failure to include an important piece of medical documentation in the application which, if included, would have changed the outcome. Azimi Law does a thorough review of its clients’ claims and medicals to assist them in filling in any gaps and in winning their LTD benefits.

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