The vast majority of group long term disability policies are governed by a federal statute, the Employee Retirement Income Security Act (“ERISA”), which has its own rules regarding how an insurance company is required to administer a disability claim. Over the years, court decisions have developed ERISA law that addresses information an insured is allowed to obtain in a litigation setting, which is also called “discovery.” Discovery can be in the form of documents or sworn testimony.
In litigation, most insurance company attorneys try to prevent insureds from obtaining any information from the insurance company besides a copy of the claim file that the disability insurer created in its trek to terminate an insured’s claim. But the claim file generally reveals only a small part of what happened. In a non-ERISA litigation setting, insurers would not get away with trying to limit a plaintiff in that fashion.
Discovery for a disabled insured is important to test and challenge the statements of the individuals working for the insurance company who rallied to terminate an insured’s disability benefits. At the risk of stating the obvious, claim files contain a lot of insurance company-favorable statements that on paper appear black and white. But when an insured is allowed discovery, it offers an opportunity to expand the landscape of the claim which could lead to a favorable outcome for the insured.
Call an experienced attorney for advice on your disputed long term disability claim.