Insurance Attorneys In Santa Clara County
Becoming disabled temporarily or permanently as a result of an injury or illness can affect people’s ability to work. If an individual is unable to work, he or she may face difficulty in paying for their daily living expenses. Long-term disability insurance provides monthly payments to individuals who are restricted from working for a prolonged period of time because of a long-term disability such as a severe injury or illness. In addition, long-term disability insurance often begins after an individual’s short-term insurance benefits end and the disability continues.
Oftentimes, insurance companies will delay payments or benefits, or they will deny claims on an unreasonable basis. Such practices mean that insurance companies are acting in bad faith. Bad faith practices on the part of insurance companies can significantly damage policyholders who have dutifully paid premiums for their long-term disability insurance. Without having the ability to work or find a replacement policy, policyholders are left vulnerable because they cannot pay for their day-to-day living expenses.
If you are facing difficulty in receiving your benefits, or if your insurer is denying your claim, contact Jachimowicz Law Group. Our lawyers will strive to obtain the benefits you are owed or eligible for.
What Does Long-Term Disability Insurance Do?
Long-term disability insurance can be provided by an individual’s employer, or the individual may purchase the insurance directly from a private insurer. The insurance company provides a monthly income benefit to disabled individuals who are unable to work. The amount of the disability benefit is set by the policy. Sometimes it is a fixed sum, e.g. $5,000 per month, and sometimes it is a percentage of the insured’s pre-disability income, e.g. 60% of $10,000 or $6,000 per month. Some policies will also reduce your monthly benefit based upon “Other Income or Benefits.” It is important to identify whether you are receiving other benefits that reduce your monthly benefit. Otherwise, you could find yourself receiving double payment and owing a significant repayment to the insurer.
If you have any questions about whether the insurer has properly calculated your benefit, please do not hesitate to contact our Insurance Coverage attorneys.
Determining The Amount Of Long-Term Disability Payments
Most long-term disability plans pay between 50% and 80% of your monthly base salary. The amount you will receive per month depends on your specific insurance policy. When calculating the policyholder’s long-term disability payment, the insurer may factor in the bonuses and overtime the policyholder received while he or she was working.
Some insurance policies apply a cost-of-living adjustment to policyholders’ benefits. Payments may increase from 1% to 3% annually if the cost-of-living adjustment is applied. While long-term disability insurance benefits can increase, they may also decrease. For example, an individual’s Social Security disability benefits may offset the individual’s monthly long-term disability payment.
Another way in which long-term disability benefits may decrease is if the policyholder returned to work. This, however, depends on whether the individual has an “own occupation” insurance policy or and “any occupation ” policy. If the individual has a long-term disability insurance plan that consists of “own occupation” policy, then the individual can work a different job that he or she was not working in during the time of application for disability insurance. However, if the individual has an “any occupation” plan, that means the policyholder cannot work at all. If the individual does work, then the insurer will regard the individual’s employment to mean he or she is no longer disabled. The insurance company may then reduce the benefits or cancel the long-term disability insurance plan.
Skilled San Jose Insurance Lawyers
If your long-term disability insurance claim was rejected, or if the insurer is delaying your monthly payments, contact the insurance coverage attorneys at Jachimowicz Law Group. We will assess the situation and the insurance policy to determine if the insurer is acting in bad faith or in breach of its statutory duties. Our legal team will aggressively fight to ensure you receive the benefits you are owed. Call us at 408-246-5500, or contact us online. We serve clients in San Jose and Santa Clara County.