A common question relates to the possibility of a settlement regarding an ERISA settlement. Let’s dive into this scenario. First, you have applied for long term disability benefits and your claim has been denied, and you’ve gone through the whole appeal process. You’ve put all the proper things in your file, making sure everything is there for the claim administrator to review your, your claim and your application and approve it. But your claim administers still denies your claim.
Filing a Lawsuit
So what happens next? After you’ve hired a lawyer, you’ve gone through the appeal process. The only thing that you can do at this point is file a lawsuit in the federal district court. Once you filed the lawsuit in the federal district court, a string of things will happen and several deadlines will come and go and everyone will file a cross motions for summary judgment, and the judge will get a copy of the administrative record. The administrative record will then show everything that you put in the file. Everything that the insurance company put in the file and a federal judge will decide if your claim should be reversed or should be affirmed.
Usually during the time where there is this discussion going on, or sometimes, the insurance company’s attorney will reach out and offer to settle your case. Now, what is the settlement value of your case? A lot of times it’s easy to calculate what the total potential value of your claim could be. We can calculate the start date, the end date, and exactly what your monthly benefit would be. We know what the full amount of your benefit could be under that policy. Don’t expect to get the full amount of your benefit under the policy, if they’re looking to settle they’re looking to mitigate the risk that they may have and keep the claim going.
You also have to account for the risk that you could lose and if you lose, because the cards are typically stacked against you in federal district court, then you get zero, you get nothing. So what is the benefit, what is the value of your settlement? It could be anywhere from 40 to 60% of the total value of your claim. It just depends on the factors of your particular case. It may be lower than that because you may have some things in that claim file that are very detrimental to a federal district court, seeing things your way.
It could also be the opposite. It could be that you have a great chance of winning your case in federal district court and you might have a good opportunity to prevail and then your settlement percentage might be a little bit higher. It’s important to seek the advice of a qualified or ERISA disability, long term disability attorney, to make sure that you know what you are entitled to in your case.
If you have any questions about that, feel free to send us an email, give us a call. We’d love to talk to you about how you can resolve your case in your best interest.