Residents of New Jersey might want to learn more about ERISA long-term disability and the reasons that CIGNA claims are often denied. There are several reasons why this might happen, and you do not want to be caught with a surprise.
What is ERISA?
The Employment Retirement Income Security Act, or ERISA, gives long-term benefits to those who need them. Studies have shown that one in five people might need these benefits after becoming disabled, and they may have disability for an average of 2.5 years.
ERISA is a federal law that governs private employers in their long-term disability insurance. It sets the standards for most voluntary retirement and health plans, and plans provide protection to employees.
Denial is common, however, especially when it comes to CIGNA plans. If you have disability insurance through ERISA long-term disability, you may have a problem collecting your insurance money. You’ve worked hard, and now it is time to receive payment from this insurance.
Some reasons for denial
Businesses want to make as much profit as possible. Because the payout comes from their profits, they want to maximize what their business makes. Sometimes, administrators who review the claims are unfair to employees; they want the best outcome for the insurance company.
Some insurers even provide incentives to their employees to deny more claims. These adjusters look for any way possible to deny your claim. They may use surveillance by video to spy on you. For example, if you just played a friendly game of basketball, the insurer may use it as evidence that you don’t have a disability. Your posts on social media may play a role as well. They might contradict your application and cause denial.
What you can do
Gathering evidence is important when you have a disability claim. Adequate medical evidence is one of the most important factors that you can control. You must have regular medical care with evidence to support it.
Ask for printed copies with dates of your doctor visit when you see your physician. Check with your insurance to ensure that they have a copy and that the insurance adjuster will have them.
If you do receive denial from CIGNA or other insurance, read the letter carefully to find out the reasons. Be aware of any important deadlines or dates for appeal.