Whether you’re concerned you’ll soon receive a disability insurance benefits denial letter from Principal or you’ve already gotten one, you’ll want to take your next steps quickly. It takes time to build a solid appeal, and waiting too long to take action can limit your options going forward. Read on for some more information on what to expect after a claim denial, what you’ll need to do to create a comprehensive record, and what to expect if your claim for benefits is ultimately approved.
Your Options Vary Based on the Type of Policy You Have
Knowing what type of long term disability policy you have at the outset of your case will dictate what aspects of your claim are emphasized and when (and how) you sue Principal to recover disability insurance benefits. Unlike some companies that exclusively specialize in group (or ERISA) long term disability policies sold through employers or private individual policies sold through insurance brokers, Principal issues both types of policies – and these two types can take very different tracks both before and during the litigation process.
ERISA claims require the claimant to file one administrative appeal, and receive a decision, before suing Principal to recover disability income benefits. The administrative appeal simply returns the case to Principal to re-review the claim, and will often result in the same outcome; however, claimants aren’t allowed to short-circuit the process by suing in civil court before the administrative review has been completed. And more importantly, this administrative review presents ERISA claimants with the last opportunity to supplement the record – which we’ll discuss in more detail below.
For private disability policies, no administrative appeal is required, although claimants can (and often do) opt to strategically pursue such an appeal before suing in court.
You’ll Likely Need the Full 180 Days to Submit a Strong Appeal
Whether you have an individual or an ERISA disability policy, it’s a good idea to take most of the 180 days that are allotted to you to prepare your appeal. Often, it’s helpful to request a copy of the claim file from Principal (although the insurance company is only required to provide this file to ERISA claimants). This claim file provides you with all the information Principal reviewed when it decided to deny your claim, and can give you a good idea of any potential weak spots or areas where further records are needed.
Taking the time to submit a comprehensive appeal is even more important for ERISA claimants. One of the biggest potential downfalls of an ERISA policy is its finality; once the administrative record is closed after the administrative appeal, no more evidence can ever be admitted in support of the disability claim. Even the most skilled attorneys in the world can’t overcome this strict legal standard, and submitting a halfhearted administrative appeal can be one of the quickest ways to stop a disability claim in its tracks.
The Vast Majority of Litigated Principal Disability Denial Lawsuits End in a Lump-Sum Settlement
If your administrative appeal isn’t successful and you file a lawsuit in civil court, you’re likely to be offered a lump-sum settlement of your claims at some point. This settlement offer can range from the value of a month or two of benefits to the value of years of benefits, depending on the strength of your claim. It’s crucial for claimants to seek legal advice before accepting a settlement, since taking these funds will terminate the policy and end your ability to pursue any further long term disability insurance benefits from Principal.
Long term disability insurance companies place strict time limits on appeals from the denial of disability benefits, and it can take some time to build a solid case. Claimants can make the most of this time by contacting Dell & Schaefer today. To get started, just give us a call to set up a FREE consultation with one of our experienced long term disability insurance attorneys.