Sun Life Long-Term Disability Denial
Hard-working Americans prepare for the worst by purchasing long-term disability insurance policies from insurers like Sun Life every day. When a bad turn of health prevents us from working, it is more-than-reasonable to expect the insurer to live up to its end of the bargain. Claim managers however, don’t always treat claimants like valued customers, but like suspects instead.
At Robinson & Warncke, we can help you file that claim and build an ironclad case file that ensures your claim is processed fairly and quickly. Or if you received a Sun Life long-term disability denial, we can help you appeal it. Call today to speak to a disability attorney.
Who Is Sun Life?
Sun Life is one of the largest distributors of disability insurance in the world. They offer both long-term and short-term disability policies. While they’re based in Toronto, they sell policies in the U.S. market and are therefore subject to ERISA (Employee Retirement Income Security Act of 1975), which applies to disability insurance available through your employer.
What does this mean for you? It means that when it comes to appealing a denial, you’re facing an uphill battle. Even in cases where your case is strong enough to move forward with an appeal, you will find that you are up against someone who will use every legal trick in the book, with full knowledge of the law, to frustrate the process.
Sun Life Long-Term Disability Policies
Unlike some disability insurance carriers, Sun Life only offers group plans through employers as opposed to individual policies. These policies are purchased by your employer. In cases where you get sick or otherwise have a condition that limits your ability to work, you may have no choice but to file a claim on your employer’s group disability policy.
Your employer will choose a plan that provides either a specific amount of monthly coverage or a percentage of your earnings. Generally, group long-term policies have longer elimination periods. That means you won’t be able to begin receiving benefits until a few months into your disability.
Sun Life Will Try to Delay, Dispute, Deny, or Terminate Your Claim
Sun Life is among the largest providers of long-term disability insurance in the U.S. and Canada. However, the insurance company has made headlines in recent years for unfairly denying claims or using delay tactics to frustrate policyholders as well as dispute tactics to intimidate them. In some cases, they have outright denied valid claims. Their tactics often include engaging in practices such as the following:
- Burying policyholders in mountains of paperwork;
- Delaying the process of making a judgment on a claim;
- Interrogating you, your family, your employer, or close friends concerning your condition;
- Basing a denial on suspect medical science or reasoning that is not widely accepted by the medical community;
- Adopting aggressive, even unreasonable interpretations of vague policy language; and
- Selectively reviewing the medical records to “Cherry pick” vague notations of improvement or “stability” of a disabling medical condition.
It’s important that you do not accept a low-ball settlement. Once your policy is settled, there’s nothing an attorney can do to help you. Let Robinson & Warncke help ensure you get the maximum amount owed to you under the terms of your policy.
Understanding the Sun Life Long-Term Disability Claims Process
Dealing with Sun Life is often a long, drawn-out process. The company does not make filing LTD claims easy on its policyholders. Immediately after receiving a claim, Sun Life may begin looking for any “legal” reason to deny your claim. And while fraudulent claims do occasionally happen, in our experience that is far rarer than insurers being the bad guys in the system. Aggressive claims denials can leave honest workers with valid claims, who are legitimately too sick to work, feeling like they’re under the microscope. That is by design.
During the process, you will need to provide Sun Life with as much medical evidence as possible to not only prove that your condition exists but that it impairs you from continuing to do the job you’re currently doing.
Those who attempt to file appeals on their own often find the process intolerably frustrating. Insurance companies can and often do request duplicate information, claim that they’ve never received information that you know you sent, or deny claims based on erroneous information.
Appealing a Sun Life Long-Term Disability Denial
Once your claim has been denied, Sun Life will inform you of your right to file an appeal. They will also provide you with a specific deadline. You must file an appeal by that deadline. It is usually at this point that most policyholders should enlist the aid of an experienced ERISA attorney. Click here to see why it is usually a bad idea to handle your own appeal: Should I Handle My Own Appeal?
Once you’ve been denied, you should ask Sun Life to send you your claim file. If you hire an attorney to handle the appeal, they should order the claim file as a first order of business. The file almost always contains valuable information that will assist in directing how the appeal should be prepared.
Your disability attorney will review the terms of your policy, look over your claim file, and submit information requests to your doctors to ensure that your proof is complete. Sometimes additional testing or examination can help better verify and quantify your disabling symptoms or restrictions and limitations. An experienced disability attorney should know enough about medicine to be able to direct that process, as well.
Sun Life wins when you give up without a fight. If even 1 in 10 claimants simply give up without appealing the decision, this translates into millions of dollars in revenue each year for Sun Life. Don’t be among those who give up or who make the mistake of handling their own appeal.
Talk to Robinson & Warncke Today About Your Sun Life Long-Term Disability Denial
Our job as your disability attorneys is to prevent Sun Life from illegally or unfairly denying your claim. Insurance companies can be sued if they don’t uphold the terms of their policies, and they can only legally deny your claim by providing both thorough and valid medical reasoning. To learn more about how we can help in filing a claim or appealing a denial, contact Robinson & Warncke today.