What Happens On A Final Denial

What happens when the insurance company denies your claim?

Clients often come to us while still in the administrative process with the insurance company.  This means the client still has at least one more appeal to the insurance company to review the medical evidence and make a decision to overturn the denial.  With respect to cases governed by the ERISA statute (the Employee Retirement Income Security Act of 1974) it is an excellent idea to contact an attorney upon receiving a denial from a disability insurer because that allows the attorney to gather evidence in support of your appeal while the file is still open.  All evidence for an ERISA case under what is called the rational basis standard of review usually closes when a disability insurer makes a final decision to deny the insured’s final appeal.  Coffman Law has helped many clients obtain an administrative reversal of a disability insurer’s denial of their claim for benefits without having to go to court.  On the other hand, sometimes the disability insurance company denies the appeal, resulting in a final denial at the administrative level, or what is called exhaustion of administrative remedies.  When a claim is completely denied, the claimant can file a law suit against the insurance company, resulting in winning, losing, or settling the case.  Coffman Law also offers appellate representation in the Eleventh Circuit Court of appeals, often giving clients another chance to win.

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