When clients come to us for representation of a denied disability claim, we always check the amount of benefits that the insurer was paying them before the denial. I am surprised as to how often the benefit amount is incorrect. Sometimes insurance companies will not include certain forms of compensation, such as bonuses, in the monthly benefit amount when the policy clearly requires bonuses to be included in the benefit calculation. We have helped several clients receive an increase in their monthly benefit amount. If you think that you are being underpaid by an insurance company, this could very well be the case.
Many of the disability insurance policies I encounter are difficult to follow in regards to the method to calculate disability benefits. Often I’ll find that the policy is ambiguous, and in such case, ambiguities should be read in favor of the insured. After all, claimants do not write the insurance policies that cover them in the event of an accident or illness. They should not be left to guess at the meaning of an insurance policy, especially while they are suffering from an illness. This is why Courts construe ambiguous policy provisions in their favor. Unfortunately, many unsuspecting claimants will receive an incorrect monthly disability benefit for the duration of the benefit period. If you are currently receiving benefits, pay close attention to the way in which the policy defines “pre-disability earnings” or “monthly earnings.” If you have any doubt as to whether you are receiving the correct benefit amount, consult an experienced ERISA attorney.