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Reliance Standard Disability Claims Lawyer

CaveyLaw.com > Reliance Standard Disability Claims Lawyer

Expert Reliance Standard Disability Claims Attorneys

Reliance Standard was founded in 1817 as an association of volunteer fire departments and over the years expanded into auto insurance and other lines of insurance. If you or a loved one are facing a claim, contact our Reliance Standard Disability Claims Lawyer today.

Reliance Group Holdings

The years of 1968 to 1998 are known in Reliance history as the “Saul Steinberg Era.” In the early 1970s, a holding company was formed knows as Reliance Group Holdings as part of a corporate strategy to expand into financial services and other insurance-related products. During the years it has owned the Days Inn hotel chain and has a real estate division. That is not surprising since most insurance carriers are in the real estate business which is where they really make their money.

However, the company began falling apart between 1998 and 2001, and Reliance being placed into liquidation by the Commonwealth Court of Pennsylvania. Reliance was the largest insurance company placed into liquidation.

Reliance Group Holdings owned Reliance Standard Life Insurance Company, among other companies, which sells disability income and group term life insurance. It is now a member of the Tokio Marine Group, a Japanese corporation founded in 1879.

Denial Tactics Used by Reliance Standard

Reliance Standard manages claims through Matrix Absence Management, Inc. which is where the claim denial and termination strategy and implementation take place.

Make no mistake about it, Reliance Standard plays games with initial applications and makes endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains your bank accounts as you try to stay financially afloat.

Reliance Standard uses “liar for hire” doctors who give Reliance Standard the ammunition it needs to justify a claim’s denial or termination. Reliance Standard rarely tells a denied policyholder, like you, the real reasons the claim was denied. Worse yet, Reliance Standard fails to fully explain what you need to submit to successfully win an appeal.

That’s why it is crucial that you be represented at both the initial application and appeal stages of a Reliance Standard claim by an experienced lawyer, like Nancy Cavey, who battles Reliance Standard daily.

Don’t Go Up Against Reliance Standard Alone

frustrated with disability claim processSome Reliance Standard policyholders make the mistake of going it alone and they pay dearly for “doing it yourself.”

Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Reliance Standard), the only recourse is to file a lawsuit.

Let me tell you the story of Ms. Jordan!

Why You Need A Reliance Standard Disability Claims Lawyer

Ms. Jordan appealed the wrongful denial of her claim and Reliance Standard’s decision was due 45 days later. Despite the fact that Reliance Standard did not make a timely decision, Ms. Jordan continued to submit evidence for two months and even went to an “independent” medical examination. She got tired of waiting for a decision and filed a lawsuit. Guess what the judge said?

In Jordan v. Reliance Standard Life Insurance Company, No. 1:16-cv-23, 2018 WL 543041 (E.D.  Tenn. Jan. 24, 2018), the Judge ruled she had not exhausted her administrative remedies and the court returned the case to Reliance Standard to make a decision.

If you purchased your insurance through your employer, the policy is most likely governed by the Employee Retirement Security Act or ERISA.

Despite its name, the ERISA statute and regulations are NOT policyholder friendly.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Reliance Standard’s file which is stuffed with medical and vocational opinions that are favorable to Reliance Standard. You didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational, or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.

An appeal of a denied Reliance Standard claim is the trial of your case. Taking on a tough insurance company like Reliance Standard is an endeavor for a specialist. A federal judge will give Reliance Standard the benefit of the doubt because your Reliance Standard policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on Reliance Standard. After all, this is about getting the disability benefits you deserve and you paid for.

Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Reliance Standard.

Don’t think that Reliance Standard isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a Reliance Standard individual disability attorney like me.

Reliance Standard’s Use of Independent Medical Exams (IMEs)

It’s not uncommon for the disability insurance companies like Reliance Standard, to schedule an independent medical evaluation.

In the case of Mason v. Reliance Standard Life Insurance Company, 14-CV-01415-MSK-NYW, 2015 WL 5719648 (D. Colo. Sept. 30, 2015), the Colorado court found that Reliance’s denial of benefits was arbitrary and capricious.

Reliance had scheduled an independent medical evaluation of Mr. Mason and he was unable to attend as he was in the hospital on the scheduled date. Instead of rescheduling, Reliance Standard hired a peer review doctor to conduct a medical review of Mr. Mason’s medical records. Of course, the peer review physician rendered an opinion that was favorable to Reliance who seized on the hired guns medical opinion as the basis for denying the claim. The Colorado Court reversed and remanded the case back to Reliance Standard. Unfortunately, this will give Reliance a second chance to have an IME and issue a new denial.

Will My Benefits Be Denied Because I Didn’t Attend An IME?

There is a good chance your benefits will be denied because your policy probably requires that you cooperate and attend the IME. If you are scheduled for an IME, it is the time to hire a disability attorney who can possibly prevent the IME, prepare you for the IME and even have if allowed, the IME videotaped or witnessed.

Disability Policies That Reliance Standard Offers:

The type of policy that you have will determine your rights and whether you are playing on a level playing field. Our Reliance Standard Disability Claims Lawyer can help you to clarify which policy you have and what that means for your case.

ERISA Disability Insurance for Groups

Reliance Standard offers disability policies through employers which are governed by ERISA. A Reliance Standard ERISA policy generally has the following:

  • strict definitions of disability and occupation,
  • limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
  • “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
  • A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if Reliance Standard’s decision is “arbitrary and capricious.”

Let me tell you the story of Ms. Watson and her fibromyalgia claim.

Reliance Standard Improperly Uses Mental Nervous Policy Limits In An Unsuccessful Attempt to Limit Benefits of Policy Holder with Fibromyalgia

Ms. Watson was disabled as a result of fibromyalgia which causes fatigue, cognitive issues, and depression. Reliance Standard accepted her claim based on depression and then terminated her benefits after two years under the mental nervous limitations of the policy.

She appealed claiming she was disabled as a result of the physical manifestations of her fibromyalgia. Ms. Watson underwent two Reliance Standard IMEs both of whom opined she was disabled as a result of depression only.  She was awarded Social Security disability benefits as a result of her fibromyalgia. Guess what Reliance Standard did in response?

Of course, Reliance Standard upheld the denial and Ms. Watson sued. In Watson v. Reliance Standard Life Insurance Company, No. 14 C 4990, 2017 U.S. Dist. LEXIS 187488, Nov. 14, 2017, the Judge found the preponderance of the medical evidence demonstrated that she was totally disabled as a result of her combined physical limitations and awarded benefits.

This case is typical of how Reliance Standard misuses the mental nervous limitation to deny benefits. Our esteemed Reliance Standard Disability Claims Lawyer can help you navigate your claim and assist you every step of the way.

Non-ERISA Disability Insurance for Groups

However, a group plan offered by a church plan, such as the Catholic Church, or by a municipal employer like the City of Baltimore, Baltimore County, or the State of Maryland is NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference. A claim’s denial or termination can be challenged in state court and new evidence can be submitted at trial.

State law courts are a much friendlier place for a policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on Reliance Standard’s file stuffed full of things that are unfavorable for you!

Individual Disability Insurance

Without a doubt, the best and most expensive policy is a private individual disability policy known as an ID policy. The policy terms and coverage are broader and more generous. But that means a high monthly premium and a lot of financial exposure that Reliance Standard has if you become disabled.

It isn’t uncommon for Reliance Standard to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits.

Reliance Standard FAQs

Below are some frequently asked questions about Reliance Standard Disability Claims.

How Do I Apply for Reliance Standard Short-Term Disability Benefits?

To apply for short-term disability benefits with Reliance Standard, you must use the company’s official claims form. This form can generally be obtained through your employer or directly from Reliance Standard. Make sure you put in the time and effort to complete the forms accurately. Minor errors can cause serious problems. In its official claims documents, Reliance Standard instructs insured individuals to do the following three things when applying for short-term disability benefits:

  1. Answer all questions listed on the claims form; 
  2. Sign the authorization for use in obtaining information documents; and
  3. Have a licensed doctor fill out and sign the physician statement. 

The insurance carrier also states that at least three months’ worth of medical records should be attached. Failure to submit sufficient medical evidence could be used as justification to deny your disability claim. If you need help applying for benefits with Reliance Standard or if your claim has already been rejected by the company, contact a Florida short-term disability attorney for help.

How Does Reliance Standard Pay Out Its Short-Term Disability Claims?

Short-term disability insurance is a form of paycheck protection. With short-term disability coverage, workers can obtain several months of income replacement benefits if they are kept off the job due to a qualifying illness or medical condition. Short-term disability benefits provide a much needed financial lifeline to many families who are going through a difficult time.

Depending on the type of coverage they have, short-term disability benefits are paid at either 40%, 50%, or 60% of a worker’s pre-disability earnings. Reliance Standard notes that the maximum short-term disability benefit for the majority of its plan is $1,250 per week. When approved, disability benefits may be paid by check or through direct deposit. If you have any specific questions or concerns about how Reliance Standard pays short-term disability benefits, contact our Reliance Standard Disability Claims Lawyer for help.

When Does Short-Term Disability Coverage with Reliance Standard Begin?

Both short-term and long-term disability benefits are subject to an elimination period. Simply put, an elimination period is a time between the date of onset of the disability and the date that disability benefits actually kick in. In other words, most short-term disability policies do not become active on the date of the disability. An applicant must wait a pre-specified amount of time before they are eligible to get disability payments. The elimination period varies from policy to policy.

Check with your Summary Plan Description (SPD) to determine exactly when your short-term disability coverage starts. Reliance Standard typically offers short-term disability plans that carry elimination periods of either 7 days and 14 days. In effect, this means that most employees have to wait one or two weeks before their short-term disability benefits can start. If you are struggling to get access to short-term disability benefits through Reliance Standard, contact our qualified Reliance Standard Disability Claims Lawyer for immediate help with your case. 

Contact Our Reliance Standard Disability Claims Lawyer Today

If you are looking to file a disability claim to Reliance Standard, or you are seeking to appeal a denied claim, get the legal help you need now. It’s time to call Nancy L. Cavey, who can represent you, regardless of where you live in the United States. Call the Law Office of Nancy L. Cavey (727) 475-7431 today for a complimentary consultation. Don’t go through this complex process alone. Costly mistakes can be made at the initial application and appeal stages of a case if you are not careful.