In addition to our significant social security practice, we represent persons who are lucky enough to have group or individual short term and long term disability insurance. For over 28 years, we have brought claims against most of the major insurance companies (Aetna, Cigna, Unum, Hartford, MetLife, etc.) for denying the disability claims of our clients – doctors, lawyers, nurses, teachers, laborers and so many other occupations. Some of these insurers pay only short-term disability (STD) benefits, but deny the same person’s claims for long-term disability (LTD) benefits. Other insurers pay LTD benefits for a short time period, only to cut off benefits thereafter for a host of improper reasons. And other carriers pay absolutely nothing at all.
The majority of people who have short and long term disability insurance coverage receive it from their employer, as a result of being within a “group” of covered persons such as the staff of all employees working for that particular employer, or a staff of particular employees, such as managers or higher-level employees. Unfortunately, such “group coverage” usually forbids the application of Florida law, and mandates the application of arguably the most unfair federal law on the books today – ERISA.
The Employee Retirement Income Security Act of 1974 (ERISA) is completely different than the law of Florida. For instance, if you buy disability insurance completely separate from what is purchased through your employer, you have a great number of weapons at your lawyer’s disposal to fight an unfair decision by an insurance company to deny or cut off disability benefits. The greatest of these weapons is your entitlement to a jury trial. For instance, if the insurance carrier denies your STD or LTD claim by saying you are not in fact “disabled” under the definition included in your policy, a jury finding that you are in fact disabled means you win your case. You get to put on all your evidence in support of your disability claims, such as the expert testimony of your treating and examining physicians and of course, your own testimony and that of your spouse and other family members. In addition, if you win, the trial judge in most circumstances MUST award you not only all your past-due benefits (plus interest), but also your ATTORNEY FEES for being forced to hire an attorney to bring your claims for you. Unfortunately, under ERISA, none of these weapons are available to you. That is why, in Mr. Soloway’s opinion, this law is so unfair.
ERISA claims are governed by a federal law that takes away your right to present your evidence in court to a jury of your peers, with automatic attorneys’ fees awardable in victory. Instead, a Federal District Judge is your fact finder. In addition, if you prove that you are disabled and the insurance carrier was incorrect in finding otherwise, you still don’t win. Instead, you are usually held to a much higher burden of proof, known as “arbitrary and capricious” conduct. In addition to proving that the insurer was wrong, you must also prove that the insurer’s conduct was arbitrary and capricious in denying your claim. The judge usually reviews only that evidence before the insurer’s claims adjuster at the time the final decision was made, and unless the judge believes the carrier’s decision was both wrong AND a result of an arbitrary and capricious review, you lose. And even if you establish this very high burden of proof, there is still no guarantee that the federal judge will award you attorney’s fees even if he is willing to award you interest on your back-due benefits. As the award of fees is based upon a multi-factored additional test, many successful claims result in no fee award whatsoever.
At the Soloway Law Firm, we talk great pride in accepting STD and LTD claim denials for representation. The fact that the laws applicable are often unfair and the odds stacked against our clients only makes our resolve to win even stronger. Mr. Soloway has been handling these claims for over 28 years and has been teaching this complicated area of law for over 20 years to other lawyers in Florida and around the country at seminars and through the internet. The insurance carriers know which law firms have experience in this area of law, and we are proud that they know when our firm is against them, they are in for a major litigation duel of wills, assets and strategy. And the strategies we have developed over many decades of state and federal disability litigation are available to you when you call the Soloway Law Firm on your STD and LTD claims.