An insurance company taking its time deciding your long-term disability claim can be frustrating, especially if you are unable to work and have no income, which is often the case. Whether you can simply file a lawsuit because you’re tired of waiting for the insurance company’s decision, however, depends in large part on the type of insurance policy you have and whether ERISA governs the policy. Individual LTD policies, however, typically are not subject to ERISA.

A federal law called ERISA or the Employee Retirement Income Security Act of 1974 governs most employer-sponsored long-term disability plans. ERISA specifically allows timeframes for insurance companies to complete different steps of the claims process.

For example, ERISA generally allows insurance companies up to 45 days to process and approve or deny your claims. However, several extensions are available for insurance companies in many situations. Initially, the insurance company can ask for a 30-day extension if it was unable to finish its investigation into the claim. If the insurance company asks you for additional information to support its claim, then you have 45 days to respond. The insurer then is eligible for another 30-day extension. Overall, then, your initial claim for benefits could take up to 150 days before you reach a decision.

Although insurers must act in good faith to process claims, some do take full advantage of these timeframes. As long as ERISA applies and the insurer acts within the parameters described above, the insurer would not be acting in bad faith. Therefore, suing the insurer under these conditions would not be successful. We know that you are facing disability-related legal issues that can be crucial to your future. As a result, the attorneys at Bonnici Law Group have the skills and knowledge to advise you of all potential options. We know how vital this support can be to you when you are unable to work. As a result, we are here to represent your interests throughout any dealings that you must have with your insurance company. For legal advice about your claim, please contact Bonnici Law Group at 858-261-5454 or help@bonnicilawgroup.com.