Teachers help take care of our children. But, what happens when teachers become disabled and can't financially take care of themselves? Watch this video for a story about a client that we helped but whose case could have been a much different story if a viable claim record had not been established early on.
A middle school football coach enjoyed a great career until one of his players died on the field. Though it wasn't the coach's fault, he took it hard. He turned to alcohol and abused medications. His health deteriorated to the point that he could no longer work.
He filed a claim for long term disability benefits under his plan and also filed for Social Security disability benefits. The Social Security Administration readily acknowledged his disability. His daughter also received a dependent benefit. However, it wasn't enough to make ends meet.
The long-term disability insurer refused to pay the claim. If the policy was provided by the public school system, it would be exempt from ERISA and he would have a claim for bad faith under state law. However, this particular benefit was provided through the teachers' association therefore it was governed by ERISA.He would have no claim for bad faith.
He hired us to pursue an appeal of the denial of his claim. We put together a strong case with a compelling record. But the insurer didn't budge.
So, we filed suit. The case was resolved within four months because of the strength of the claim record we had established.
Having a strong claim record is critical to later success filing suit under ERISA. We know what must be included and how to present and preserve a claim record that will support a lawsuit if necessary. Don't make the mistake of trying to preparing one if you have never done it before. Unlike most cases, these can be one or lost before suit is even filed.