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SHORT-TERM DISABILITY CLAIM DENIAL

CALIFORNIA INSURANCE LAWYERS GIANELLI & MORRIS CAN HELP YOU GET THE DISABILITY BENEFITS YOU NEED

Suffering a serious accident, whether inside or outside the workplace, is a jarring experience that can leave you uncertain about your future.  As medical bills and other expenses mount, many injured people find themselves unable to perform their normal job duties, either temporarily or permanently.  Your short-term disability insurance (STDI) is meant to start shortly after an illness or injury and provide you with a percentage of your income until you are able to get back to work or until your long-term disability insurance (LTDI) policy kicks in.

Unfortunately, insurance providers often look for reasons to deny or delay STDI benefits, challenging your inability to work or the extent of your injury.  STDI benefits are meant to start shortly after you become disabled, and any delay in payment or limitation on coverage can leave you in dire financial straits.  Policyholders dealing with stubborn insurance providers or employers can look to Gianelli & Morris for help.  Our California insurance bad faith law firm has decades of experience working exclusively in the area of insurance law.  We’ve fought for countless individuals who have been denied the benefits due under their policies.  We know the law, we understand the policies, and we know how to get insurance companies to pay what they owe.

What is Short-Term Disability Insurance?

Short-term disability insurance, or STDI, is a form of insurance that is meant to pay out some or all of an employee’s income that they are missing as a result of injury or illness.  STDI is not meant to be a permanent solution to disability; LTDI policies are there for the long-term.  Instead, STDI typically lasts between three to six months and may last as long as a year.

STDI benefits start to pay out after the initial waiting period, also called the “elimination period.”  The elimination period for STDI is typically within 14 days.  STDI can be a useful alternative or addition to LTDI coverage.  LTDI policies may require an employee to be unable to work for 90 days or as long as six months to a year before benefits will be triggered.  STDI can provide workers with income in the meantime, covering the gap until LTDI begins or for the entire period of a shorter-term injury or illness.

STDI is often provided through and paid by employers, although individuals can purchase their own STDI plans either separately or through their employers.  The cost of an STDI policy will depend on a variety of factors, including the elimination period, the benefit period, the coverage amount, and the nature of the policyholder (age, health, occupation, risk factors, etc.)

How Much Income Replacement Does STDI Cover?

STDI plans vary on how large a percentage of the policyholder’s income will be paid out.  Different plans may pay anywhere from 50 to 100 percent of the employee’s pre-disability income, but STDI usually provides somewhere around 80 percent.  LTDI, on the other hand, usually pays out around 60 percent of pre-disability income.

What if My STDI Claim is Denied?

If your STDI claim is denied, you do not have to accept the decision as final.  You have the right to challenge that denial both internally with the insurance provider and externally.  If your claim was denied in bad faith–if you were not given the reasons for denial, if those reasons were fabricated, if the investigation of your claim was unjustifiably delayed, or if the provider utilizes other bad faith tactics–you may be able to recover not only the benefits you are owed but additional legal damages as well.  The insurance denial attorneys at Gianelli & Morris have years of experience securing insurance benefits for clients who have been denied the coverage they are due.

Will a Short-Term Disability Claim Affect My Long-Term Disability?

Many policyholders choose to purchase both short-term and long-term disability coverage.  As we have discussed, STDI can be used to cover a large portion of your income while you wait for LTDI benefits to begin.  You will typically be able to continue receiving STDI benefits until you reach the time limit or total benefits cap under your policy, or until you become eligible for LTDI coverage.  The specific terms of your policy may vary, but typically you will not be able to receive dual benefits under both policies at the same time.  You will still be able to collect STDI benefits even after applying for LTDI coverage, however, but not once you begin receiving benefits.  So long as nothing in your application for STDI and your regular updates to your claims administrator disqualifies you for LTDI coverage, your STDI coverage should not interfere with your eligibility for LTDI benefits.

Contact Gianelli & Morris for Help With Short-Term Disability Insurance Claims Denials in California

For help with a denial of your STDI claim or other short-term disability insurance issues, call the California insurance lawyers Gianelli & Morris at 213-489-1600for a no-cost, confidential consultation. We’ll take the time to evaluate your situation and let you know how we can help.

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