If you’ve recently filed a disability insurance  claim with Equitable (or are just thinking of filing a claim), you’re not alone. Here at Dell & Schaefer, we see disability insurance denial letters from Equitable on nearly a weekly basis and have helped dozens of claimants secure the benefits they’re owed. Learn more about the process of filing a disability insurance claim with Equitable and what disability insurance claimants should be able to expect.

The Type of Policy You Have Matters

Before filing a claim for disability benefits, you’ll want to determine whether you have an individual disability insurance  policy or a group or ERISA disability policy.

An individual long term disability insurance policy is a contract between the disability claimant and the insurance company. These policies are more expensive than the group policies generally offered through an employer, and the old adage “you get what you pay for” often applies – an individual policy provides the disability insurance claimant with far more rights, both before and during litigation, than a group policy. The individual policy may have a more generous definition of “disability” (e.g. providing benefits if you can’t perform your job vs. paying only if you can’t perform any job), a more generous standard of review on appeal, and the right to a jury trial. Individual disability insurance policies are usually litigated in state court.

A group or ERISA disability insurance  policy, on the other hand, requires claimants to administratively appeal a benefits denial letter (and be denied again) before they have the right to sue their insurance carrier. Once the appeal is decided, the administrative record is closed, and any subsequent disability lawsuit can’t introduce any information or evidence that isn’t contained in this administrative record. Group policies are litigated in federal court, and to prevail, a disability claimant must show that their disability claim was denied for an arbitrary reason.

Though Equitable Has High-Quality Policies, Approval Can Still Be Tough

Some disability insurance policies have a laundry list of exclusions and exceptions that can mean many otherwise-qualifying disabilities may not be covered. Equitable isn’t one of these companies; it has a solid reputation in the disability insurance industry as a carrier that offers good policies at a good value.

But this doesn’t mean disability claim approval is an automatic process. In addition to offering quality long term disability policies, Equitable administers these policies through a third party, which means you’ll be negotiating with Disability Management Services (DMS), not Equitable, about your claim. Adding a middleman to the disability claim process can complicate matters, and because DMS deals exclusively in approvals and denials, they have extensive experience in drilling down to the meat of a claimant’s allegations and finding reasons to deny coverage. A claimant can majorly benefit from hiring a disability insurance attorney with specific experience in negotiating with Equitable and DMS.

If Your Claim Settles, You’ll Usually Receive a Lump-Sum Payout

In about nine of every 10 disability claims, the insurance carrier will offer a settlement before trial. For the carrier, pre-trial settlement can help avoid the preparation and expense of a disability trial, along with the risk of losing and being responsible for a judgment. For disability claimants, a settlement offers a sense of certainty and eliminates the risk that their claim will be unsuccessful at trial. When a claim settles, the claimant is usually offered a lump sum payout (the present value of future payments) rather than an ongoing benefit obligation.

If you’re an Equitable disability insurance  policyholder and are wondering about your disability insurance options, Dell & Schaefer can help. Our team of attorneys often negotiates settlements with Equitable and can help you achieve a resolution that works for you. Give us a call or visit our website today to set up your FREE consultation with one of our experienced disability attorneys.