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Worthington Legal Issues Blog

Can you sue over life and accidental death insurance disputes?

Having insurance policies in place typically makes residents of Ohio feel secure about the future. This is particularly so when you acquire life insurance and/or accidental death insurance. While no insurance payout can make up for the loss of a loved one, it can help the bereaved face the future without suffering financial hardships.

Unfortunately, there are times when insurers deny claims filed by a deceased person's family members. In some cases, the denial may be justified, but in others, the insurer has no valid reason to issue a claim denial. These unfair denials can lead to life and accidental death insurance disputes, which complicates the process of healing after the death of someone you love.

Protecting your pension contributions from misuse

Losing all or even part of a pension plan is one of the most devastating events you could face in your lifetime. Like most Ohio residents, you have worked very hard and very long to build a nest egg that will fill your needs upon retirement. Even though the last thing you want is a pension dispute, you may one day need to deal with such a dispute if your retirement funds are at risk.

Many of us who work in America contribute to pension plans with our own personal funds. Typically, we trust the investors in charge of our retirement funds to make wise, well-informed investment decisions. In most cases, this trust is justified, but sometimes, investors misuse our contributions. As laymen, we might not know our funds are in danger, but there are ways to spot such misuse. Below are several warning signs indicating possible misuse of pension plan funds.

  • Your pension account balance is different from what you expected
  • Your statements reflect investments that you did not authorize
  • You see evidence of unusual transactions such as loans to your boss or your pension trustee
  • Your account statement does not show the contributions that you have made
  • Your account balance experiences a significant and unusual drop in funds
  • Your account statements arrive late or not at all

Examples of employer ERISA violations affecting Ohio residents

The Employee Retirement Income Security Act (ERISA) is comprised of federal laws developed to protect the workforce. Those who qualify for ERISA work for private companies that offer employees retirement plans, health insurance and other benefits.

As with other federal benefit programs, ERISA can be complex. This means that it is easy for employers to violate the program. In most cases, the employer does not want to interfere with a worker's benefits, but it can happen all the same. Below you will find several of the most common ways an employer can violate ERISA plans.

  • Wrongfully denying current or former employees access to their benefits
  • Interfering with the rights of workers who are covered by these plans
  • Breach of the employer's fiduciary duty to employees covered by ERISA

Do you have a bad faith claim against the life insurance company?

Your loved one spent years faithfully paying premiums for the life insurance policy in which you were the beneficiary. Upon his or her death, you expected to receive the proceeds of that policy.

When you file a legitimate claim, the insurance company refuses to pay on the policy or fails to process your claim in a timely manner. What is going on here? Is the insurance company acting in bad faith?

What are the pros and cons of long-term disability insurance?

Ohio is full of hard-working individuals who want to make certain they remain protected in the face of a debilitating illness or injury. Many people approach such concerns by comparing different types of disability insurance policies. For some, long-term disability insurance is the logical way to avoid a future financial disaster if tragedy strikes and renders them unable to continue working.

As with all insurance plans, there are advantages and disadvantages to disability insurance. One of the most troubling cons involves dealing with long-term disability disputes when an insurer refuses to pay a claim. Other cons associated with long-term policies include the following:

  • Most people must endure a waiting period of 90 or more days before they can collect on their claims
  • Often, long-term disability insurance policies only cover the insured for a specific length of time (typically two to five years)
  • You may lose some of your Social Security benefits when you choose a long-term disability policy

Think ahead to avoid severance disputes down the road

Employment in the 20th and 21st centuries is much different than it was decades ago. Many members of the Ohio workforce know better than to accept an unfair employment agreement, for example. Despite this increased attention to detail, some workers still walk away from a termination with an unfair severance package.

It is safe to say that no one wants to deal with severance disputes addressing unfair treatment, but what other options exist for employees? Thinking ahead can be a solution to help you avoid severance disputes before they have a chance to occur.

COBRA and other health insurance disputes: Employer obligations

Knowing that you have health insurance goes a long way in helping you feel secure about your physical well-being. When you have insurance coverage through your employer, those feelings of security may be even stronger. What happens if you lose your job or if your employer reduces your work hours? Will you have to start over and find coverage on your own?

These are the questions that plague Ohio workers anticipating a change in their employment status. Unless you are well-versed in matters of insurance, you might not realize that COBRA, an acronym for Consolidated Omnibus Budget Reconciliation Act, provides you with continued coverage in certain situations. Events that can trigger COBRA include getting laid off or terminated and having your work hours reduced.

Common reasons for long-term disability claim denials

Undoubtedly, having long-term disability insurance of any kind gives Ohio residents peace of mind. These forms of insurance act like a comfortable safety net in case the worst ever happens and you can no longer work to support your family. The last thing you expect in these cases is to receive a denial notice that may lead to long-term disability disputes.

When you feel that you have done nothing wrong yet cannot collect the disability benefits you deserve, one of your first questions may be why you received a denial. There are many reasons why insurers deny long-term disability claims. Below you will find a few of the most common reasons.

  • If your disability will last for less than one year, you may receive a claim denial for long-term benefits
  • You may fail to meet a technical requirement of the policy (length of time off work, degree of disability or nature of disability)
  • If drug or alcohol abuse led to or contributed to your disability, you can probably expect a claim denial
  • If you do not have an accurate and in-depth treatment record for your disability, the insurer may reject your claim
  • Errors such as lack of documentation or failure to attend hearings can also result in claim denial

Why do insurers deny life and accidental death claims?

Knowing that you are covered by an insurance policy in case of your or a loved one's death gives people a deep sense of security. It all seems very cut-and-dried when you purchase a policy or when your employer provides insurance coverage. Unfortunately, many Ohio residents who thought they were covered find themselves suddenly facing life and accidental death insurance disputes.

The first thing you should understand is that insurance companies are businesses. As such, they have an interest in holding onto their funds rather than paying out claims. While it is not personal, it certainly feels that way to those of you who are counting on insurance policy payouts. There are many reasons insurers deny claims, which often leads to time-consuming life and accidental death insurance disputes. These reasons include:

What you can expect from long-term disability insurance

When choosing benefits through your employer, you may have been fortunate enough to have numerous choices. Perhaps you receive health insurance, life insurance and disability insurance options.

You may have opted into short-term disability insurance before in case you suffer a work-related injury, but never really considered long-term disability insurance. Maybe knowing a bit more about it will help you make an informed decision.

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Law Offices of Tony C. Merry, LLC
7100 North High Street
Suite 302
Worthington, Ohio 43085-2567

Phone: 614-372-7114
Fax: 614-505-6109
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