Helping Clients Get the Insurance Benefits They Are Entitled To
Each Chicago insurance lawyer at Bryant Legal Group PC is devoted to helping policyholders navigate insurance contracts and resolve insurance claims with their carriers. Our lawyers have decades of collective experience working with clients to obtain the benefits they are owed under their disability, life and long-term care insurance policies. We know how insurance companies operate and are well aware of the obstacles they will put in your way to prevent you from receiving the money to which you are entitled.
How Our Insurance Lawyers in Chicago Can Help You
Our Chicago insurance law firm works with clients who have purchased insurance privately or receive benefits from their employers or unions. We never represent insurance companies and work exclusively for insureds. This focused experience grants our attorneys the deep knowledge and legal toolset necessary to take on complex disputes and hostile insurance company defendants.
We have vast experience battling powerful companies and is well equipped to advise clients in broad range of insurance law matters, including:
- Private Disability Insurance Policies
- IDI Policy Claims And Appeals
- IDI Policy Litigation
- Life Insurance Policies & Claims
- Life Insurance Denial
- Bad Faith Insurance Claim
- Self-Employed Disability Insurance
- Group Insurance Disability
- Physician Disability Insurance
Providing Critical Advice and Counsel to Policyholders
Insurance contracts are complex agreements drafted by insurance companies. Because these agreements are so technical in nature, it can be extraordinarily difficult for individuals to fully understand policy limitations and exclusions without the advice of an experienced attorney.
Every Chicago insurance attorney at Bryant Legal Group PC have vast experience interpreting the complicated clauses and provisions included in insurance contracts. We speak the language of the insurance industry and know how to help our clients avoid potential pitfalls that may be buried deep within an insurance contract. We also have the experience and knowledge base to assist insureds who are filing, appealing and/or litigating claims in Chicago and throughout the country.
With our broad reach in the marketplace, we are able to resolve some of these claims without litigation. However, due to the significant financial exposure claims pose to insurance companies and opposing interpretations of case law or the facts, we prepare every case for the downstream possibility of litigation.
Why Avoid Litigation?
Generally speaking, civil litigation — in the insurance dispute context and otherwise, such as in a personal injury dispute — can be time-consuming, emotionally frustrating, expensive, and in some cases, quite disruptive. Civil litigation is also public. Simply put, the details of your dispute including the medical information related to your disability claim will be disclosed and available for public access. Insureds who are concerned about their privacy may therefore prefer to resolve their dispute before the case proceeds to trial.
At Bryant Legal Group PC, we approach insurance disputes comprehensively and aggressively. We believe that by thoroughly preparing for the possibility of trial litigation, we put our clients in an advantageous position during early negotiations. Insurance companies also want to avoid the negatives of trial litigation, and as such, if they see that you are well-prepared for trial and that you have strong arguments supporting your claims, they are more likely to award you benefits (or negotiate some other favorable settlement).
Consistent and comprehensive advocacy is part of our DNA as a law firm. For example, we work with experts — medical, vocational, and others — to evaluate your benefits claim and determine best-fit strategies that are most likely to help your case.
In the event that litigation is necessary, our Chicago insurance law firm will work to make the experience more palatable — we understand that clients have different goals and budget limitations, so we offer flexible fee arrangements that are personalized to suit the needs and preferences of each client.
Wrongful Denials and Insurer Strategies
In general, insurers — whether in the context of life insurance, disability insurance, health insurance or others — employ certain strategies in order to avoid having to payout benefits, even when the claim seems (upon first impression) to be legitimate. This is a common problem, especially in situations involving a significant amount of potential benefits, such as a life insurance payout or a disability insurance payout where the insured is a high-earning professional.
Strategically, if the insurer can impose a significant enough hardship on the insured-claimant, then some portion of policyholders may simply resign themselves to the adverse determination of their insurer. For example, if an insurer grants you only partial disability benefits, they may do so in the hopes that you will not have the willingness or funds to challenge their decision and thereby secure full disability benefits.
Insurers understand that you may be put in a vulnerable position after a claim denial or undervaluation and they engage with insureds with this power dynamic in mind. It’s therefore critical that you consult with qualified insurance lawyers in Chicago who can advocate aggressively on your behalf and communicate (to the insurer) your willingness to fight for the benefits that you’re owed.
Of course, insurers are not legally allowed to simply deny a claim or make any other adverse determination without some “reasonable basis” to do so. For example, an insurer may argue that there is insufficient evidence to support your claim for disability benefits, as it’s not clear whether your condition actually prevents you from working in “any occupation.” Even if the facts tend to support your arguments, so long as the insurer can argue that there is room for a reasonable dispute, then they will likely have no problem denying the award of benefits so as to gain a strategic advantage.
Insurers are required to adhere to a duty of good faith with respect to their insureds. In non-ERISA plans, if the insurer violates their duty of good faith (perhaps by unreasonably delaying the processing of your benefits), then you may have an actionable bad faith claim against the insurer, if you purchased your policy in a state where there is bad faith law. If there is evidence of bad faith, you’ll almost certainly want to litigate the claim — bad faith claims can give rise to significant damage awards, including punitive damages (which multiply the compensatory damage total).
With complex insurance disputes that involve bad faith claims and the wrongful denial of benefits, we encourage you to get in touch with a qualified Chicago insurance law firm for assistance. Firms with specialized insurance dispute experience, such as Bryant Legal Group PC, are capable of effectively navigating these complex disputes on your behalf.
On What Basis Do Insurers Justify Their Denial of Benefits?
Insurers may deny benefits — life insurance, disability, health, etc. — for a number of different reasons. Consider the following.
Insurers may refuse to payout benefits (and may revoke coverage) if the policy at issue has lapsed due to a failure to make premium payments. Importantly, however, insurers have a duty to formally notify policyholders of missed premium payments so that the mistake can be corrected before the policy lapses. Policyholders usually have a 30-day grace period (for making the payment at issue).
Incomplete Claim File
Insurers frequently deny benefits claims on the basis of an incomplete or otherwise inadequate evidence. For example, if you submit a claim for disability benefits, but your application does not have sufficient documentary evidence (medical records, expert reports, vocational reports) to support your claim, then the insurer will likely deny benefits. It’s important to work with a Chicago insurance lawyer early, as a skilled one will identify relevant evidence and make absolutely certain that your administrative record is complete.
Applying an Exclusion
Most policies feature various exclusions that give the insurer the right to deny benefits. For example, life insurance policies generally feature a “suicide clause” that allows the insurer to deny benefits if the insured committed suicide. Though it may initially seem as though a broad exclusion prevents the recovery of benefits, that’s not always the case — in fact, depending on the circumstances, you may be able to present evidence that challenges the narrative in question and that redefines how the event is perceived.
For example, let’s consider a quick life insurance situation. Suppose that an insured person dies after swallowing a cocktail of prescription drugs. The insurance company will likely try to paint the situation as a suicide, even though the official records have not necessarily confirmed that the death was a suicide. You could introduce evidence to challenge the insurer’s viewpoint of the event at issue, however. Perhaps you could show that the deceased individual was not intending to commit suicide but was, in fact, taking medicine that he was recommended by a physician — the deceased may have simply been misinformed about the dangers of the combined prescription drugs in question.
Misrepresentations are somewhat common in the insurance context (both intentional and unintentional misrepresentations). If the insured makes a material misrepresentation — in other words, if the insured misrepresented or omitted information on their insurance policy application that would have affected their insurance coverage — then the insurer is entitled to reduce the benefits payout in accordance with the premium payment differential, and in some cases, may be entitled to deny benefits altogether.
Whether a misrepresentation on the insurance application is “material” is the core issue in such disputes. You will be able to counter the insurer’s argument by showing that whatever misrepresentation or omission was made was unintentional and would not have affected your insurance coverage. For example, if you lied about your place of residence on your disability insurance application, it’s unlikely that the insurer could reasonably deny benefits on the basis of that misrepresentation — after all, the insurer would have to somehow demonstrate that the address was material to their provision of insurance coverage.
Failure to Mitigate Losses
All insured policyholders — in Illinois and elsewhere — have a duty to reasonably mitigate their losses. Failure to mitigate losses may reduce one’s potential benefits or lead to an all-out denial of benefits. Mitigation need not require extraordinary effort, of course. Insureds must exercise reasonable effort, however, in minimizing their various losses.
Consider a typical disability claim scenario:
Suppose that you are a disability insured. You are injured in a car accident, and you suffer serious mobility losses (due to damage sustained in your limbs). Physicians believe that you could regain most of your function, if you consistently attend physical rehabilitation sessions and follow your overall treatment plan. Instead, you irregularly (and rarely) attend sessions, and you do not follow the treatment plan recommended by your physician. Under such circumstances, the insurer would have a fair argument that you did not reasonably mitigate your losses — had you simply followed the recommendations of your physician, you would have regained limb function and your disability would be “cured.”
Contact a Chicago Insurance Lawyer at Bryant Legal Group PC Today
If you have questions about an insurance policy or need assistance with the submission or appeal of an insurance claim, Bryant Legal Group PC is here to help. By consulting with one of the experienced Chicago insurance attorneys at our firm, you will be given salient advice and legal guidance on all aspects of the insurance contract, from evaluating new policies, to applying for benefits, to appealing and litigating claims. Insureds are our only priority, which means that whether we are negotiating a settlement with the insurance carrier, challenging a denial, or taking a dispute to court, you can trust that we will do everything in our power to get you the results you are looking for.
Bryant Legal Group PC offers flexible fee arrangements and our attorneys will come to you if you are disabled and unable to travel to our Chicago office. Call an experienced Chicago insurance lawyer at our firm today at (312) 561-3010 or email us at email@example.com so that we can find the solution that best fits your needs and expectations.