Disability insurance policyholders whose insurance premiums come out of their paychecks (often with after-tax money) are stunned when, after years of paying for coverage, the disability insurance company turns around and denies their claim. They often feel like the rug has been pulled out from under their feet, and they are left wondering why the company that promised to do so much is instead leaving them out in the cold. It’s a frightening feeling.
At the Law Office of Justin Frankel, PC, we hear these stories on a daily basis. People who are coping with the stress of a disability illness or the results of an injury, who would like nothing more than to return to their regular lives, are left in a terrible financial position. We can help.
Trademark is a mutual holding company that offers a wide range of employee benefits to employees. The company positions itself as selling “voluntary” benefit products, that is, people who seek to increase their coverage options for disability and other insurance products. The idea that you’d apply for additional disability insurance benefits only to be turned down for them creates even more frustration and anxiety for disability claimants.
Trustmark sells short- and long-term disability insurance policies. They are among the companies that own their own third-party administrator company, Trustmark Disability Advisors. This means that the company that reviews your claim to determine whether or not you should receive disability benefits is owned by the company that would pay the benefits. Can they give an unbiased review of your claim? We don’t think so.
Trustmark has also administered claims for other insurance companies or has purchased those blocks of business and now manages those risks themselves, causing them to worry about each dollar paid.
Trustmark is a big company with a team of doctors and lawyers to battle against disability insurance claims. Going up against such a big company on your own is a risky move, when so much is at stake. While the claim forms may be available online, that doesn’t mean they are easily completed.
Disability insurance companies are known for cherry-picking medical records, that is, picking out the sections that support your ability to work, and failing to include the entire medical record when they are sent for a review. Any misstep could be fatal to your claim, or serve to limit benefits in some way.
The portion of the form that needs to be completed by your physician poses a host of challenges. Unless your physician has had experience with disability claims, they may not know that what they include or fail to include on your form could doom your claim. Any mention of a mental or nervous condition, for instance, could cause the insurance company to try to push you into a mental/nervous claim, even though your disability is related to a completely different condition. The mental/nervous claim exposure is usually only for 24 months, and then payments stop.
If the doctor’s report does not include a full description of what your occupation’s physical or mental requirements are and how and why your disability has left you unable to complete the tasks of your job, the disability insurance company is likely to deny a claim. Just having a condition or an illness is not enough to warrant a disability claim payment. If it seems like the disability insurance company is playing games with language just to get out of paying or to delay paying claims, we have to say that’s true. We have seen far too many cases of people who are critically ill or injured and have their claims denied.
First of all, note the date of correspondence from Trustmark (or any other insurance company involving a denial of disability benefits). Your policy includes provisions with strict time limits for appealing a claim. If you receive a notification by mail and don’t want to deal with it, hand it to a trusted family member and ask them to call our office at 888-583-4959 for a free consultation.
Do not just set the letter aside and hope that the problem will somehow be resolved. It won’t.
The last thing someone facing a health crisis wants to deal with is a battle with their disability insurance company. The Law Office of Justin Frankel, PC represents many claimants who hand their entire disability matter over to us. We are able to relieve them of the burden of dealing with clerks and claims managers who seem to want only to make their claim so difficult that claimants give up. There is nothing for the disability insurance company to lose by denying your claim.
Even if your battle to retain your coverage goes to court, there are no damages that can be asserted against the insurance company. Their only cost will be the legal fees of their in-house counsel. You, on the other hand, have everything to lose. We have seen disability insurance companies, including Trustmark, try to wear down and wait out claimants. The strategy seems to be to push back and hope that if you are sick enough, maybe you’ll just give up.
That’s when we come in.
When we get on the phone with the insurance company, they know that you haven’t given up, you’ve just entrusted your disability claim to an experienced law firm that knows how to handle these situations.
We also work with claimants who have tried and failed to apply for benefits from Trustmark, been denied, filed a claim, and then tried to tackle the claim on their own. This is a big company with many resources, and the appeals process is complex. If you fall into this category, we urge you to call our office and speak with us about your situation.
We can help – but you have to make the call. Contact us at 888-583-4959 for a free consultation about your Trustmark disability claim.