What Happens On A Final Denial

What happens when the insurance company gives you a final denial on your claim?

When the insurance company issues a final denial in the administrative process, it’s time to file suit.

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.  Cremeens Law Group PLLC 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.  Cremeens Law Group PLLC also offers appellate representation in the Eleventh Circuit Court of appeals, often giving clients another chance to win.  There is a statute of limitations on the amount of time you have to file a lawsuit for a disability insurance final denial.  Call us today at 813-839-2000 or use the contact form on our website and we will get back to you as soon as possible.  A final denial from the insurance company doesn’t mean it’s over!