Ronald C. Burke - New York - Long Term Disability Attorney

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Most long term disability policies provide significant contractual rights to the policy holder. Mr. Burke represents individuals who have filed a claim and have been denied benefits. He also represents those who are preparing to file a claim. With careful preparation of your application and an accurate presentation of the medical evidence to support the claim before it is reviewed, Mr. Burke will maximize the opportunity for a successful claim review or submit a complete record as the basis for litigation.

Remember, the disability company is well represented by highly skilled attorneys, physicians and claims representatives who do not have your best interests in mind. The disability company may offer a policy holder who is receiving monthly benefits a lump sum settlement that is grossly unfair. In some instances the policy holder has been receiving disability benefits for years when the disability company disclaims further responsibility on the erroneous grounds that their insured supposedly recovered from the disabling illness. Mr. Burke will help you level the playing field with preparation and legal representation.

Your employer may provide long term disability benefits to you as part of your overall employment compensation package or you may have arranged for this type of coverage privately. This coverage should not be confused with Social Security Disability (SSD) benefits or employment related disability benefits that you may be entitled to as part of workers' compensation.

What is a Long Term Disability Policy?

Long term disability insurance disability policies generally provide a monthly benefit to people who have been disabled from their employment for more than 90 days. Whether due to an accident or illness and regardless of whether someone is at fault, if you have a long term disability insurance policy you should promptly file an application or claim if you are unable to work.

What You Should Do If You Have Been Denied Coverage

If you have been denied coverage by your long term disability insurance company, you must act promptly to protect your interests by consulting with an attorney. This kind of insurance policy imposes time limitations that contractually require you to file a claim, administrative appeal and/or lawsuit within a short period of time. There have been many reported cases where totally disabled people have been denied benefits until the insurance company was challenged by a lawsuit resulting in either a favorable settlement or verdict.

Lump Sum Settlement versus Restoration of Benefits

Whether the disability claim is resolved through negotiation without litigation or settled during litigation, or successfully resolved after a trial, there are different ways we can help compensate you. Some disability claims are resolved through litigation that results in a lump sum settlement of the past and future benefits owed. In this manner, the disability claimant can avoid future entanglements with the disability company, who would otherwise maintain the right to periodically conduct physical examinations and review medical/financial records.

If a claim is successful, there is always a lump sum settlement for past benefits due; however, the future benefits can be restored on a monthly basis until the disability company's obligation to pay comes to an end. (Most long term disability policies provide benefits until the age of 65 or for the life time of the policy holder.) This, of course, requires the disability policy holder to continue cooperation for the balance of the policy term with the same disability company that wrongfully denied benefits. Settlements must be considered against the possibility of success or defeat in litigation. A successful verdict against a disability company in New York will result in the recovery of all past monthly benefits due, inclusive of 9% statutory interest and restoration of future monthly benefits. You may also be entitled to reimbursement of reasonable attorneys fees if your claim is covered under a federal law commonly referred to as "ERISA".

Alternatively, sometimes both the disability company and claimant prefer to negotiate a pre-trial resolution of the future benefits owed in the form of one lump sum payment. For example, your future disability benefit entitlement can be approximated by multiplying the remaining years prior to reaching age 65 (or balance of lifetime expectancy depending on the policy) multiplied by the amount of the future monthly benefit. A calculation of the current cost to purchase an annuity that would pay out the same amount of disability benefits over the future is then considered in establishing the "present value" of all future payments. The future monthly disability benefit may include a contractual annual cost of living increase, or the disability company may be entitled to a set-off if you receive other benefits, such as social security disability.

If you believe your insurance company has breached the insurance policy by unfairly refusing to pay benefits, call or email us for a free consultation.

News You Can Use

In November of 2002, the CBS News program "60 Minutes" aired an investigative report entitled: "Did [Disability] Insurer Cheat Disabled Clients?" The expose published allegations of dishonest and deceptive business practices by former claims representatives of a major disability insurance company. This disability insurer reportedly processed 400,000 disability claims annually. According to the report, the disability insurer had set targets or quotas for claims handlers to meet in denying disability claims with bonuses for those employees who met the quotas.

Click here to read the transcript of the investigative report.

RONALD C. BURKE

Attorney at Law

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(516) 965-4370

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Long Term Disability