Sue worked for decades as a visiting nurse for a major health network in Seattle, Washington when she was diagnosed with a severe digestive disorder that kept her from traveling to her patients’ homes. When she applied for long-term disability through her employer’s policy, Reliance Standard Insurance denied her claim and her appeal that followed.
These denials are all too frequent among long-term disability claims, and the system is heavily tilted in the insurers’ favor. Because of complications in her case, Sue called and hired us at the Roy Law Group to help prosecute her claim against Reliance Standard. Her attorney navigated the complex appeal process without charging her upfront fees.
In the end, and after years of struggle, we finally got Sue the judgment she deserved. The judge found Reliance Standard had improperly denied her claim and ordered them to pay what she was owed, plus interest and even some of her attorney fees. We also had her claim reinstated going forward for as long as she remains disabled under the long-term disability plan.
Read Ray vs. Reliance Standard Life Insurance to see the full case details and the decision.
ERISA law gets complicated quickly
Sue is far from the only person to find herself on the wrong end of an Employee Retirement Income Security Act (ERISA) disability claim. Thousands of individuals go through the same thing every year. In many cases, people will try to resolve the situation themselves, even filing their own appeals. Too often, they spend months and years battling red tape, waiting for the benefit they’re owed, only to end up with nothing at all.
The problem: long-term disability is an incredibly complex, technical area of law. ERISA governs it with nearly 500 pages of arcane legal code detailing how these claims must be handled. Make one small error, miss one filing deadline, and you may never have a chance to correct that mistake.
It all came down to a simple error
You do have rights under ERISA, but the law is so insurer-friendly, even glaring mistakes on their part don’t guarantee that a claim will go your direction.
In Sue’s case, Reliance Standard’s denial was based on an error in the “vocational review” process. The insurer had incorrectly listed Sue’s job description, stating she was a home care nurse working in one location, instead of a visiting nurse who travels from home to home, daily.
It’s understandable when seeing an error like that to think you can work with the insurer to fix it on your own.
Unfortunately, big insurers like Reliance Standard have little incentive to work with you. In many cases, they only correct mistakes like these after a judge has ordered them to do so. Or, until they see the claimant has hired expert legal representation. Frequently, a big insurer will reverse course and pay what they owe right away to avoid going to trial.
You don’t have to go at it alone
Do you have a long-term disability claim that has been wrongfully denied by a big insurer like Reliance Standard Insurance? You can beat the big insurers. However, it can be a long, difficult journey, and you don’t have to go at it alone.
Call Roy Law Group today to set up a consultation.