One of the trends of managing disability claims is that claimants and insureds are trying to manage by themselves without paying for additional help. As a result of that, I’m getting more calls from claimants whose claims have been unfortunately denied.
After checking with several attorneys who are now asking outrageous back/forward fees, claimants who called me were looking for expert help without the six figure fee that went along with it. I used to do appeals a long me ago, but after winning them all Unum recognized how much money I was costing them and I had to fight for my right to represent claimants in the Portland business court.
It was decided that I would not be allowed to represent insureds up front with the insurance company, but that I would still be allowed to assist claimants with their appeals should they decide to file appeals on their own. In other words, my attorney and I won with a compromise.
It really doesn’t matter, though, ERISA allows claimants under ME Title 24A 4 (A) and to wit ERISA 29 CFR 2560.503-1(b) (4) “claims procedure of an ERISA-covered plan cannot preclude an authorized representative of a claimant from acting on behalf of such claim in pursuing a benefit claim or appeal……” to chose a representative for claims management as well as for appeals.
As I mentioned, in the last several months, (not my clients, mind you) four claimants contacted me to assist them with their claim appeals. To date, WE WON ALL FOUR APPEALS.Now, that’s quite a record. Although I did not represent my clients up front as a lawyer would, I was able to help them in gathering appeal information, obtaining appropriate medical to support claim continuation, and assistance with the appeal cover letter. I feel really great about knowing there are four people out there receiving benefits who might have lost them permanently, or at a staggering cost.
Experts can make a difference when it counts. Although there can be no projections as to outcome, having an expert on board to provide assistance can make a difference between a denied claim, and a paid one. Remember, I’ve been managing claims for over 25 years, and you can use that knowledge to help you, whether you need claims management or appeal assistance.
Please feel free to contact me about your claims management, or appeal. For more information you may go to my website located at: http://www.disabilityclaimssolutions.com
or call: 207-793-4593
My email is: lindanee.dcs@gmail.com
