MassMutual Insurance Appeal of a Denial of Disability Benefits
If MassMutual Insurance has denied your claim for disability benefits, you may feel disheartened and overwhelmed. However, it is essential to recognize that a denial is not the end of the road. The attorneys at Robinson Warncke have recovered more than 100 million dollars in insurance benefits that insurance companies tried to deny.
If you do not know your legal rights as a policyholder, it can be challenging to work with MassMutual insurance. Understanding the nuances of your policy and your personal situation can be difficult for anyone, including non-specialist attorneys in this field of law.
Working with an experienced and competent attorney frequently determines whether you will be able to win your appeal or be required to sue the insurance company. Our attorneys recognize your frustration, and we want to assist you in prevailing against MassMutual. When appealing a denial of benefits from MassMutual, there are a number of essential factors to consider.
This article will guide you through the process of appealing MassMutual’s denial of disability benefits.
- Understanding the Disability Insurance Denial of Benefits Reasons
- Appeals Procedure
- Collecting Proof for Your Appeal
- Working with an Attorney to Compose a Letter of Appeal
- The Importance of Tenacity
Disability insurance is intended to provide financial assistance to individuals who are too sick to work. MassMutual Insurance is a well-known disability insurance policy provider. Unfortunately, many legitimate claims for disability insurance are denied. Importantly, if you have been denied disability benefits by MassMutual Insurance, you have the right to appeal the decision.
MassMutal Disability Insurance Overview
Disability insurance is intended to restore a portion of your income should you become disabled and unable to work. In terms of coverage, premiums, and eligibility requirements, policies can vary greatly. It is essential to thoroughly examine your policy to comprehend your coverage and eligibility requirements.
Justifications for Refusing Disability Benefits
There are numerous grounds for denying a disability claim. Common explanations include:
- Lack of medical evidence to support the claim
- Failure to satisfy the policy’s disability definition
- Incomplete or inaccurate information provided on the claim form
- The claim was premature.
- The policy excludes coverage for the claimed category of disability
- The policyholder did not comply with the pre-claim waiting period.
- Exclusions for conditions pre-existing
If your disability claim has been denied, the first step is to familiarize yourself with the appeals process. The appeals procedure can vary based on the insurance company and policy, but typically consists of the following steps:
- File an administrative appeal or a request for reconsideration – If MassMutual initially denies your claim, you usually should not file a lawsuit immediately. Depending on the provisions of your policy and the applicable law, you may be required to file a “administrative appeal” (if your claim is governed by ERISA) or a request for reconsideration (if it is not) with MassMutual. This is the most crucial phase in your claim, and this is where a disability expert attorney can be of the most assistance. For justification, please see here.
- Gathering Evidence for Your Appeal – When appealing a denial of disability benefits, it is essential to gather as much evidence to support your claim as feasible. This can include medical records, physician statements, and even arranging specialized testing that confirms and measures your disabling symptoms, providing objective evidence of your work restrictions.
- Writing an Appeal Letter – Writing an appeal letter to the insurance company is a crucial step in the appeals procedure. Your appeal letter should include a thorough explanation of why you believe your claim was improperly denied, as well as any supporting evidence or documentation. At Robinson Warncke, our appeal letters routinely run 20-plus pages, single spaced, analyzing the evidence and explaining in detail why the insurance company was wrong to deny your claim.
- Working with an Attorney – As stated here, attempting to handle your own appeal is almost always an error. Consider consulting, if not employing, a disability insurance claims specialist attorney. A lawyer can help you comprehend your legal rights and options, as well as guide you through the appeals procedure. Also, keep in mind that the majority of attorneys will provide a free consultation with your initial phone contact to help you determine if you require assistance.
- The Significance of Tenacity – The process of appealing a denial of disability benefits can be lengthy and aggravating. However, it is essential to maintain tenacity and not give up. Keep track of all correspondence with the insurance company, and check on the status of your claim on a regular basis. You may be able to successfully appeal the denial of your disability benefits if you persist.
- Submit statements and evidence to contradict any new reports or information generated by the insurer during the appeal process. In many instances, the insurer is required by law to provide you with an opportunity to respond to any new expert reports it obtains. This duration is typically very brief.
- If your claim is denied despite an external appeal, you may want to consider legal action. This may entail submitting a lawsuit against the insurance provider or working with an attorney to negotiate a settlement.
- If you have been denied disability benefits by MassMutual Insurance, the experience can be distressing and difficult. However, it is essential to recognize that alternatives exist. You will presumably be able to successfully appeal the denial of your disability benefits by understanding the appeals process, gathering evidence, and working with an attorney when necessary. Do not surrender. Remember that persistence can ultimately pay off.
FAQ’s About Denied Disability Claims from MassMutual Insurance
- What should I do if my disability claim is denied by MassMutual Insurance? – You have the right and possibly the legal obligation to file a timely appeal of the decision. Typically, the appeals procedure involves gathering additional evidence to support the validity of your claim and requesting a MassMutual internal review. Before you take any other action, you should first contact a specialty law firm like Robinson Warncke for a free consultation.
- What type of evidence do I need to collect for my appeal? – As much medical evidence as feasible should be gathered to support your claim. This may include medical records, additional testing, physician statements, and other evidence demonstrating the severity of your disability and inability to work. Oftentimes the most critical evidence is additional testing that can objectively confirm and measure the functional restrictions you have that prevent you from working, whether those restrictions are physical, mental, or both. Most laypeople don’t even know where to start when it comes to providing this kind of detailed, objective evidence. That is where an experienced law firm specializing in disability claims can provide a major benefit.
- Do I need a lawyer to appeal a disability benefits denial? – Appealing on your own without legal representation is almost always a major mistake. In fact, it can torpedo a winnable claim. We have reviewed numerous cases in which an unrepresented claimant caused irreparable harm to their case, even when the disability should have been winnable with professional assistance. Although you are not required to work with an attorney, an attorney can be most beneficial during the appeals process, not after. A lawyer who specializes in disability insurance claims can assist you in comprehending your legal rights and options, arranging testing and medical opinions, and guiding you through the appeals process.
- How long does the typical appeals process take? – The appeals procedure can vary by insurance provider and policy. An effective appeal of a denial of disability benefits could take several months.
- If my appeal is effective, is it possible to obtain retroactive benefits? – Yes, if your appeal is successful, you may be eligible to receive retroactive benefits for the time period during which your claim was denied.
If you are reading this before the deadline for your appeal, contact an ERISA expert immediately for a free phone consultation. When we prepare the administrative appeal, Robinson & Warncke’s attorneys have a 95% success rate in obtaining payment of benefits. Call our firm immediately; we will defend you.