People in New Jersey who have private or employer-sponsored temporary or long-term disability insurance may have an important financial safety net if they suffer disabling injuries or illnesses that prevent them from returning to their jobs temporarily or permanently. However, some disability claims that are filed are denied. The rights that you have when your disability insurance benefits claim is denied depend on whether you have private disability insurance or are covered through an employer-sponsored plan.
Rights with employer-sponsored short- and long-term disability insurance
Many people have short- or long-term disability insurance through their jobs. Like other employer-sponsored benefits plans, disability insurance plans that are offered through employers are covered by the Employee Retirement Income Security Act. If your claim for benefits under an employer-sponsored plan is denied, your rights are more limited. While you have the right to appeal the decision, ERISA mandates that you must exhaust all internal remedies before you can file a lawsuit. Pretrial discovery is more limited, and you will not have the right to have a jury trial. Finally, punitive damages are not available for ERISA claims.
Rights with a non-ERISA plan
If you purchased private disability insurance and receive a denial of your claim, you have more rights than if you have an employer-sponsored plan. People with private disability insurance do not have to exhaust their insurance companies’ internal appeals process and can directly file lawsuits against their insurers in court. Pretrial discovery does not have the same limits and normal discovery rules will apply. You will also have the right to a jury trial and to seek punitive damages.
Disability insurance offers people peace of mind that they will be protected if they become disabled and are unable to work. It can be overwhelming to receive a denial of your disability claim. The attorneys at The Law Offices of Steven Gaechter fight for the rights of people whose disability claims have been denied and understand the regulations that apply under ERISA for employer-sponsored plans. To learn more about the differences between private disability insurance and ERISA plans, you might want to review the information we have on our ERISA and non-ERISA disability claims page.