Lincoln National Delays But Pays Back Injury Disability Claim
Severe back injuries disable our client
Lincoln National Life Insurance Company had done nothing but dilly-dally with our client’s disability claim. Lincoln National is a disability insurance company which is part of the Lincoln Financial Group. Our client, a 60+ year old man who worked for a nationally known R.V. company, came to us after Lincoln refused to pay his Long Term Disability claim following two back-to-back rear-end car accidents. The car crashes left him unable to return to his job due to a spinal disability and his inability to walk, sit or stand. His injuries to his neck and low back were so severe that even the strongest pain relievers, Fentanyl and morphine, could not take the edge off his constant, chronic pain. None of that matter to Lincoln National.
Lincoln National sits on the disability claim, and refuses to pay LTD benefits until we sue them
Lincoln’s disability adjusters failed to make a decision on our client’s long term disability benefit claim. They did not respond to multiple e-mails, letters, and calls over the course of nearly 9 months. When he came to us, he normally would have had to wait for a denial letter and then appeal the denial before filing suit because ERISA regulations require a claimant to “exhaust remedies.” However, using a little known provision in the law, our experienced ERISA lawyers in the disability division of Tucker & Ludin, P.A. filed a lawsuit arguing that the claim was “deemed denied,” because the disability insurance company failed to act.
Hiring ERISA counsel worked for our client. Lincoln gave in, and paid our client over $110,000 in past due LTD benefits. and got Lincoln to agree that it improperly denied benefits by failing to decide the claim. Lincoln Financial also agreed to review our client’s claim and evaluate his condition to see if additional monthly benefits were payable.
However, even though our client was paid his past due benefits, guess what happened again!
Lincoln took no action on his continuing benefits!
When Lincoln National’s claim representatives started evaluating whether our client remained disabled and entitled to continuing LTD payments, it went on radio silence. It failed to make a decision about whether our client continued to meet the definition of disability. In the meantime, Social Security decided that our client was so disabled that he could not perform any occupation in the entire national economy.
Even with the Social Security determination and countless letters and calls to Lincoln, its disability examiners dragged their feet and did not make a determination for another 8 months.
Lincoln National finally pays the claim.
After focusing on particular evidence that showed our clients level of disability, our disability attorneys were able to get Lincoln to approve the claim. Lincoln offered no explanation why it took so long, but we are happy to report that our client’s monthly benefits are now being paid. His family finally has regular monthly income coming in from the disability insurance he paid premiums into for years.