Nichols & Pina, LLLP attorney Ted Pina has been representing individuals with disability claims under group and individual disability income protection policies since 1996. Ted’s disability income clients have represented a cross section of the work force, from school teachers to physicians and corporate managers. Ted has helped these clients at all stages of the claims process from filing of the initial application for benefits to negotiating buy outs of individual policies to the filing of lawsuits in state and federal courts.

Disability income insurance policies are contracts between an individual and an insurance company. Individuals pay monthly premiums so that their income will be protected if they suffer a disabling illness or injury. Unfortunately, individuals filing claims for disability often find themselves unexpectedly confronted with an unfamiliar and complicated claims process and an adversarial insurance company that is more interested in protecting its bottom line than in honoring its contractual obligations. Before you apply for disability benefits or deal with a disability income insurance company you should consult with an attorney who can help guide you through this often frustrating process.

There are many types of disability income insurance policies. Understanding the particular features and language contained in your policy is vital to your ability to collect disability benefits to which you are entitled. Some important questions to ask include:

• Is your policy a group or individual policy?
• How does your policy define “disability”?
• Does your policy use an “own occupation” or an “any occupation” disability standard?
• Does your policy provide benefits for total and/or partial (residual) disability?
• How long or to what age are benefits payable under your policy?
• How does the definition of disability change?
• Depending on how old you are when disability begins or depending on the type of illness you suffer from? e.g. mental/nervous conditions?
• What is the amount of the benefit payable for total or partial disability?
• How is the amount calculated?
• Are there cost of living adjustments over time?

Having a firm grasp on these issues will help insure that you receive the benefits to which you are entitled under your policy. Our firm can help you understand your policy and avoid traps and pitfalls in the application process. We can also help you if it becomes necessary to take legal action to obtain your benefits.

All claims for disability benefits begin with the filing of an application for benefits. While application forms often seem straightforward, this is, in reality, a complex process with many hidden pitfalls. Filing a claim requires careful coordination with the disabled individual and his or her treating physician and often with others including accountants or coworkers and supervisors. For that reason, it is often the best course to consult an attorney before filing a claim for benefits.

Our firm can help complete the application process by working with you and your physician to ensure that the claim is presented properly and timely with supporting documentation of disability and loss of income. Our firm can also help throughout the claims process by dealing with the insurance company, responding to requests for information and documentation, and making sure the company complies with the terms and conditions of the policy.

Often times, however,  even when a claim is timely presented with proper supporting documentation, benefits will be denied, delayed, or stopped. When this occurs our firm can help you obtain benefits either through a negotiated pre-suit settlement or by litigation. Ted Pina has handled multiple law suits against many major disability insurance companies in state and federal court and has no hesitancy to file suit when necessary to secure benefits.

If you or someone you know is considering filing a disability claim, or has had a claim denied by your insurance company, let the attorneys at Nichols & Pina help.