Long Term Disability Law Blog
If Dearborn National recently denied your claim for long term disability benefits, you may be wondering what your next steps should be. In most cases, appealing the denial of disability benefits will require a claimant to file a lawsuit, but the path such a lawsuit may take can vary widely based on the policy’s language. Learn more about what claimants are likely to expect when filing a long term disability insurance lawsuit against Dearborn National.
Is Your Dearborn National Policy an ERISA or Non-ERISA Policy?
Dearborn National writes both ERISA and non-ERISA long term disability policies, and these two different types of disability claims can take very different tracks.
The Employee Retirement Income Security Act (ERISA) is a federal law that tends to be much more insurer-friendly than employee-friendly. ERISA governs the group long term disability policies that are offered through a claimant’s employer, usually at a low cost to the claimant. The adage “you get what you pay for” can come into play here, as ERISA policies tend to make it far more difficult for claimants to qualify for long term disability benefits.
Non-ERISA policies, known as individual long term disability policies, are purchased on the open market (or through an insurance broker) and tend to be more comprehensive and more expensive than ERISA policies. Many individual policies will provide disability benefits until a specified age (like 60 or 65) or even for the claimant’s lifetime, as opposed to ERISA policies that will usually terminate benefits after a couple of years.
Non-ERISA Claims Come With Some Major Advantages
ERISA policies are litigated in federal court, applying federal law. To prove a claimant is entitled to benefits in an ERISA lawsuit, the claimant must prove two factors: (1) they are disabled under the terms and definitions of the disability insurance policy; and (2) Dearborn National acted in an “arbitrary or capricious” way in denying the first claim for benefits.
Proving a claim was denied arbitrarily or capriciously can be a challenge, and short of a showing that the packet was incomplete when it was received or that the claim investigator reviewed the wrong file, claimants may find this threshold tough to clear. This is a large reason why only about 15 percent of ERISA claimants prevail in a lawsuit, with the insurance carrier winning around 85 percent of the time.
Non-ERISA policies are litigated in state court, applying state contract law. This means the outcome of a case can turn entirely on how the state in which the claimant lives applies insurance contract law. Dearborn National operates on a nationwide basis and has little interest in learning the ins and outs of insurance defense under each state’s law, so this can often spur non-ERISA claims to settle out of court.
The Time Frame for Resolving Your Dearborn National Lawsuit Can Vary
Because the paths for ERISA and non-ERISA claims can look so different, and because the facts of each long term disability claim are different, it can be tough to affix a standard answer to the question of how long a Dearborn National long term disability lawsuit will take. However, having an attorney can ensure your claim doesn’t end early in a firm denial. Contact the experienced disability insurance attorneys at Dell & Schaefer today to set up your FREE consultation.