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Some people will buy their own disability insurance coverage because they are freelancers or contractors, but they feel they have to be covered if they have an accident or illness that will keep them out of work. Others buy individual disability insurance as a supplement to employer-provided coverage. These individuals may have a high-risk job, or their pay is part salary and part commission, and the employer coverage will not be enough if they miss work due to a disability. Individual disability insurance supplements their employer-based coverage and mitigates their risks from an accident or illness. They can purchase either short term or long term disability coverage individually.

The experienced individual disability insurance lawyers at Capitan Law realize the importance of individual insurance claims for our clients. Our attorneys have a firm understanding of the application process, the laws surrounding disability, and the tricky tactics used by insurance companies as they attempt to deny disability benefits. If you have questions about your insurance policy or need assistance with applying, or if your benefits have been unfairly denied or terminated, we are here to help. Call us today at (267) 419-7888 to schedule a free and confidential consultation so we can discuss your legal options. We will fight to protect your rights.

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    Why hire a lawyer for my individual disability claim?

    Are there special needs and circumstances for people who buy individual coverage and then file a disability claim? Do they have to hire a lawyer to help them get benefits from these individual disability providers? Is there anything about these policies that might even require the skills and experience of an expert disability claims attorney?

    First of all, you probably need a disability insurance lawyer well before you purchase individual disability insurance. When an employer purchases long term disability insurance, they work with insurance brokers and other expert advisers to pick the most appropriate coverage for their business. These experts know how to read an insurance policy. They understand the special language used to describe key aspects of the coverage and also know what the business tradeoffs are so their client, the employer, doesn’t buy too much coverage or not enough. Unless you have the required skill set to do these things, you would need to hire someone with the requisite knowledge to help you make the right choice. At Capitan Law, we read these policies all day long and will be able to help you find the most appropriate individual disability insurance coverage.

    Cases We Handle

    At Capitan Law, we handle disability benefits claims for you from start to finish. Types of cases we handle include:

    • Individual Disability Insurance
    • Short-term Disability Insurance
    • Long-term Disability Insurance
    • ERISA Benefit Claims
    • Cigna Disability Insurance Claims
    • Hartford Disability Insurance Claims
    • Unum Disability Insurance Claims
    • Prudential Disability Insurance Claims
    • Aetna Disability Insurance Claims
    • The Standard (Previously Standard Insurance) Disability Insurance Claims
    • Reliance Standard Disability Insurance Claims
    • Lincoln Disability Insurance Claims
    • MetLife Disability Insurance Claims
    • Sun Life Disability Insurance Claims

    It is important to know that we work on a contingency basis. You don’t pay us a retainer or any other fee. We get paid when we get your benefits paid. When dealing with disability insurance coverage, we are able to explain the complicated insurance terminology to you. We will review your needs and inform you about the key aspects of disability insurance:

    • Residual versus total disability analysis. How much will you receive in benefits, based upon the extent of the disability?
    • “Own occupation” versus “any gainful occupation. Some disability insurance may require you do get a job well beneath your abilities and live on that income instead of receiving disability benefits
    • Mental and nervous disability benefit limitations. Because metal and emotional disability are not as visible or easily diagnosed as physical disability, your policy may not pay out benefits for crippling mental disorders.
    • Self-reported conditions benefit limitations. The insurance carrier may require proof of disability, but things like extreme back pain, etc., cannot be proven or quantified with diagnostic certainty. But they may still prevent you from working.

    Do not worry if any of this terminology is new to you. We understand it and will explain it to you, helping you make the right choice of an individual disability insurance plan.

    The person who purchases this individual insurance will fill out the application themselves. In our experience, this is problematic because, if there ever is a claim filed against the policy, the first thing the insurance carrier will do is give the application very close scrutiny. In employer-based coverage, the application process is handled by someone in human resources with experience in adding new individuals to an existing policy. They know what information is needed and how to fill out the form correctly. But the person signing up for individual disability coverage is probably not accustomed to the forms or the terminology, as well as the supporting documents needed to get the coverage.

    However, an experienced disability claims lawyer will know exactly how to fill out an application for individual coverage and will get it right. This is extremely useful to the insured. There is nothing worse than buying an insurance policy, paying the premiums and, when you need the insurance because you have a claim and you need the benefits, finding out a mistake or omission on the insurance application means you will not receive those benefits. When you hire Capitan Law, you will have a lawyer who knows how to handle this situation and can make sure the application is filled out correctly.

    Why Choose Us?

    With our help, you may select the right individual insurance, fill out the application correctly, stay current with your premiums and then suddenly you have an accident that keeps you out of work for months. In this case, you will file a claim. We help you with that, too. We know exactly what disability insurance companies are looking for in terms of medical documentation, and we will provide a satisfactory explanation of how the injury prevents you from working. Even then, your claim gets denied.

    The insurance company will have lawyers and experts lined up against you. You absolutely cannot fight them on your own, but you will not have to, because Capitan Law will manage your claims appeal and, if necessary, file a lawsuit against the insurance carrier. As much as you need an advocate fighting for you, you also need skilled professionals who have seen insurance companies keep delaying the process, as they ask for reams of paperwork and medical documentation in an attempt to wear you down until you are willing to settle for less. The experienced attorneys at Capitan Law will make sure none of that happens.

    All the preparation you and Capitan Law worked on together, the careful selection of the right insurance coverage with a reputable company, the proper application process, the writing of a claims document with proper supporting information, was all about being in a position to have a successful appeal if you ever have a disability claim denied. Insurance companies do not want to pay out money, but the individual disability insurance policies they sell are contracts with requirements that they have to pay you if you do everything right and are disabled and cannot work.

    As you can see, a skilled and experienced disability insurance attorney is needed to protect your interests when dealing with individual disability insurance companies. In fact, two of the most important things we can do for you have not even been discussed yet: negotiation and litigation. The appeal process is nothing more than an extended negotiation between the defense (insurance company) and the plaintiff (the insured). There are many aspects of these negotiations that are formalized and stuffed full of jargon. How injuries are assessed? Precisely, what is covered and what is not covered? How long is the benefits payout likely to last? If there is a cap to benefits, in terms of time or the percentage of your salary? All of these things and much more will be on the table during the negotiation process.

    All of our years of experience have taught us something about what makes for a successful negotiation: fear. Insurance is an industry famous for its aversion to conflict and controversy. What will make for a successful appeal of your claim is Capitan Law’s willingness to file a lawsuit against the insurance carrier if they are not willing to offer a fair and reasonable settlement of your claim. Simply put, we have successfully sued some of the biggest companies in the disability insurance industry, and no company will be happy if they walk into a courtroom and see us sitting at the plaintiff’s table. So, they settle, maybe for a bit more than they were planning, but that is to your benefit. We live for the negotiation-and-litigation aspect of being successful disability insurance lawyers. We will represent you to the best of our abilities and do everything we can to make sure you get the maximum benefits you need and deserve.

    Frequently Asked Questions (FAQs) About Disability Claims

    At Capitan Law, we get a lot of questions from clients regarding their disability claims. Below are some of the most commonly asked questions. We hope that you find our answers to these questions helpful. If you have any questions about your particular case, don’t hesitate to reach out to us any time at (267) 419-7888.

    Long term disability benefits are provided to an individual by an insurer to replace their lost income after they have sustained an injury or illness resulting in an inability to work. They are different from workers’ compensation benefits, state disability benefits, and Social Security Disability Income (SSDI) benefits because they are not mandated by law and are not provided by state or federal government. Long term disability benefits are either provided by the employer as an employee benefit or they are purchased by the individual.

    If an experienced disability lawyer is involved early on, they will be able to guide you through the complicated claims review process, leveling the playing field against the insurance company and strengthening the chances of your disability claim getting approved. An attorney can also help make sure that the proper evidence gets in the claims file if you have to file a lawsuit to recover your benefits.

    Long-term disability insurance obtained through an employer is typically governed by a federal law known as Employee Retirement Income Security Act (ERISA). Under this law, certain procedures must be followed in the claim process. You have to follow all these steps in seeking benefits and before you can sue your insurance company.

    Contact Us

    The skilled disability attorneys at Capitan Law understand how to develop the evidence necessary to build the strongest case possible for you. We will meet all the deadlines, negotiate with the insurance company on your behalf, and file a lawsuit if necessary.

    The experienced disability attorneys at Capitan Law are here to help. We offer free and confidential consultations on all individual disability insurance matters. To discuss your case with a skilled and compassionate individual disability lawyer, contact us today at (267) 419-7888.

    Written by : Joe Capitan

    Last Updated: February 26, 2024
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