The Law Office of Justin Frankel has worked with many claimants who have either short- and long-term disability benefits with Lincoln Financial, or with Lincoln National Corporation, Lincoln National Life Insurance Company, and its other subsidiaries. For this coverage, people were willing to have money deducted from their paychecks to protect their families if they were to become unable to work. However, many claimants have experienced significant pushback when trying to file their rightful claims. Delays and denials of LTD claims appear to be on the increase.
Numerous claimants reported that their application for benefits was met with requests for extensive documentation not required by their disability policy and report that the process feels like tennis balls — bounced back and forth between different departments. Repeated requests for the same information, from different people, over extended periods of time seem to be a particular strategy of Lincoln Financial Disability.
Another common tactic seen is saying that they have not received any information at all or that they did not receive medical reports properly. Sometimes, a representative may decide that the extensive medical records sent are still not enough and will then request personal financial information that is often not required by the policy terms.
The unsympathetic, often attacking responses from a long-term insurance company claims manager to a person who is already suffering from a disability is a frustrating and infuriating tactic. Claimants are often made to feel like they are doing something wrong for being unable to work. It’s just one reason why many people contact the Law Office of Justin Frankel, a nationwide disability law firm, when they realize they are up against a giant insurance company that is going to do its utmost to subvert long-term disability claims and fail to honor their contractual obligations.
Lincoln Financial Group is a large American-based insurance company that owns many other insurance and investment companies. In 2018, Lincoln purchased Liberty Mutual’s group benefits business (including its disability business), which provided a massive boost to Lincoln’s presence in the group disability market. The company offers both short- and long-term disability insurance benefits for various companies. Lincoln’s annual letter to shareholders extols the purchase of Liberty Mutual and the company’s focus on returns to investors.
The conglomerate giant has a well-earned bad reputation based on its bad faith practices and tactics. Over time, Lincoln has issued countless denials for individual, short-term, and long-term disability claims, denying disability coverage to scores of employees through its corporate clients.
Essentially, instead of providing promised coverage and paying the benefits justly due, Lincoln Financial works hard to deny and terminate as many claims as possible. That is common within the insurance industry, and expected to some extent, but Lincoln Financial often takes things to a new level. In its LTD claims handling, Lincoln Financial will do the following to deny coverage:
Due to their propensity to wrongfully delay or unreasonably deny legitimate long-term disability claims, many lawsuits have been successfully pursued against this corporate giant by policyholders.
To date, many lawsuits have been filed against Lincoln Financial and its subsidiaries for a variety of reasons. Lawsuits are based on misrepresentation of policy terms, denying LTD claims without fair reviews, changing policy and then terminating already approved benefits on previous terms, and approving and then terminating benefits without just cause, to name just a few.
To prove your Lincoln Financial disability claim, you’ll need to provide documentation to support your disability insurance claim. Essentially, you must demonstrate you have a disability (or illness) that reduces your ability to perform the tasks and duties of your occupation and you cannot perform your job as a result. Obtain the following documentation to provide to your attorney:
You will also need to provide vocational evidence including job description, employment history, and other relevant details.
Lincoln Financial has a history of resisting approval for LTD claims. Many factors will be considered, including the elimination period, the type of disability being claimed, how thorough the original claim’s documentation is, and whether deadlines have been met.
For long-term disability insurance claims under ERISA, most policies have a 45-day limit for companies to respond to initial claims and there may be extensions depending upon the policy. Non-ERISA claims must respond in a “reasonable” timeline, meaning the company has leeway to set timelines and deadlines. Unfortunately, this is a relative term and does not mean quick processing. Whether you have to appeal will also affect how long an approval takes.
Claims for the group protection segment (LTD claims) are managed by in-house claim specialists and third-party administrators. Disability claims management is understood to be critical to profitability, as results depend on both the incidence and the length of approved disability claims. In other words, if you are 45 and file a claim, expect your disability claim to be scrutinized since the potential benefits are payable for many more years.
Often, an insurer such as Lincoln will request an IME (“Independent Medical Examination”) in an attempt to determine the cause, severity, and prognosis of a claimant. Usually, this IME is performed by a doctor you don’t know and has “loyalty” to Lincoln Financial or a third-party vendor that Lincoln regularly engages. Under the policy terms, you must attend this appointment. Here are some tips:
Always keep in mind the doctors conducting the IME are not impartial or neutral, even if they claim they are independent.
To protect yourself against Lincoln Financials’ bad practices, be sure to maintain good records and keep your documentation together.
Be sure to keep records of every interaction you have with Lincoln Financial representatives. Send all documents to them via certified mail. If your claim is delayed, ask for specific details.
Chances are you’ll receive a letter detailing why you were denied. When the letter comes, review the reason and check to see whether it matches your policy. If it doesn’t, plan to hire a knowledgeable disability attorney to file an appeal. For an ERISA appeal, you must do this immediately. The insurance company is required to respond within 45 days for ERISA appeal.
Your best course of action is to hire an experienced Lincoln Financial disability insurance denial claim attorney who knows how to fight this company.
A number of clients come to us when they are having problems getting their short-term disability benefits paid. The business model has changed from past arrangements, and often the same company handles short- and long-term claims. A short-term claim needs to be treated with great care, as it is how the insurance company gathers information that can be used to delay or deny a claim when it transitions to long-term.
The concept is simple: the short-term claim is an evidence-gathering period. Here’s what you may not know about the long-term disability claims process that the insurance company knows:
ERISA is a federal law established in 1974 that sets “minimum standards” for most voluntarily enacted retirement and health plans. This law has specific rules in place, so if a company doesn’t adhere, it can be held accountable. Lincoln Financial is notorious for its bad faith denials, and its claim decisions are frequently appealed. You will have to follow specific procedures to file your appeal. Working with an experienced ERISA attorney gives you an advantage over trying to appeal on your own.
The term “bad faith” linked with insurance is when the company attempts to renege on its obligations to those individuals covered under a policy. They may:
The insurer may also attempt to underpay a claim without providing a justifiable reason for its decision.
Before you initiate a lawsuit against Lincoln Financial on any ERISA long-term disability claim, you must first exhaust any and all administrative remedies. If you fail to do this, Lincoln Financial has a stronger defense against your lawsuit, and the court may side in its favor in dismissing the action. Be sure to discuss this with your attorney to ensure you meet all current requirements for exhausting your administrative remedies. After doing so, you should initiate a lawsuit if your insurance did not comply with claim procedure regulations or failed to provide and full and fair review of the claim.
Our client was a successful clinical neurologist practicing in the area of movement disorders in a busy hospital with a focus on complex, advanced stages of Parkinson’s disease and dementia. Her tasks required the ability to perform physical and labor-intensive activities while working at an equally high level of analysis and cognitive abilities. Her patients’ lives were in her hands.
She developed a number of complex symptoms, including severe fatigue, weakness, muscle atrophy, shortness of breath, and painful muscle cramps and spasms. These were later diagnosed as early motor neuron disease, neuron mitochondria disorder, and pulmonary insufficiency. Our client could no longer perform the tasks of her highly demanding occupation. She filed a claim for short-term disability benefits with Lincoln and was denied, based on a paper review of the medical records conducted by a staff nurse.
In preparing her appeal, we worked closely with our client and her treating physicians to further develop the medical support in the record, clearly documenting the tasks that her job required and the restrictions and limitations of her illness. We vigorously attacked the credibility of Lincoln’s paper medical analysis, highlighting the many flaws in their medical review. We made it clear that they had failed to fully and properly review our client’s medical records and understand the tasks required for her to perform her profession.
We won the appeal, and Lincoln paid our client the short-term benefits that she deserved. This set the stage for her claim for long-term benefits. Without this positive outcome, she would not have been able to file for long-term benefits.
The appeal was represented by Justin Frankel, at the Law Office of Justin Frankel who has helped many professionals in demanding and complex careers when their disability insurance companies have resorted to a simplistic paper review of claims. If you would like a free consultation, call the Law Office of Justin Frankel at 888-583-4959.
Our clients choose the Law Office of Justin Frankel for disability cases because of our client-first philosophy and meticulous attention to detail. When you hire our law firm, you will always work with Justin Frankel. Our attorneys have years of experience dealing with insurance companies and the long-term disability claims/appeal processes. At the Law Office of Justin Frankel, you can expect to always receive compassionate and tenacious representation. Our team approach is buttressed with seasoned paralegals to assist Justin Frankel.
“Justin and his team including Christina are outstanding. The insurance companies make it difficult for the disabled, however, they are no match for Justin and his experienced team. My case was extremely difficult and I personally had lost hope but Justin kept me positive. He stacked my case with medical evidence, scientific backup and vocational expert support. I am very fortunate that I found his firm, Justin cares about the individual and not only did he win my case but he negotiated a very beneficial deal on my behalf. He is an amazing, experienced attorney that will do everything possible to win your case, don’t hesitate and make sure he is on your side!” -Gigi A.
Anyone encountering problems with their Lincoln Financial Group disability insurance policy can contact the disability insurance attorneys at the Law Office of Justin Frankel to discuss your situation. The call and the case evaluation are free.
Our attorneys will be with you every step of the way and will take on the entire burden of fighting with the disability insurance company so you can focus on your health and recovery. We are located in Long Island, New York, but we help claimants nationwide.
The insurance company has all the advantages unless you have the Law Office of Justin Frankel on your side. Call us today at 888-583-4959.