As we face challenges due to the Coronavirus (COVID-19) please follow the the recommendations of the CDC and your local medical community. I am available to my clients and new clients by phone, email, teleconferencing and if necessary and safe, in person meetings. The best way to contact me is direct email: jonathan@erisaattorneys.com. Stay well and help others in need.

  • 866-816-3171

Has Your Insurance Company Denied
Your Disability Claim?

Whether an insurance company, employer, union or other ERISA governed
plan has denied your insurance claim, we can help.

What Happens If I Have a Long-Term Disability Policy and I Can’t Pay the Premium?

If you become disabled due to an illness or injury for which qualifies you to receive long-term disability payment, usually you no longer need to pay premiums. Most policies contain a waiver provision that provides in substance that if you qualify for long-term disability benefits, you are not required to pay premiums while you are on claim.

3 Things You Need Examine

  1. Does your policy include a waiver of premium rider or is the waiver of premium part of the main policy?
  2. Understand the insurance company’s definition of a disability.
  3. In the case of a disability you need to know how long the insurance will company waive the premium?

Here’s How Waiver of Premium Works If You’re Disabled

If you have a waiver of premium rider or part of the main policy, if you are disabled due to sickness or injury for which you qualify for disability payments, the insurance company will waive the provision requiring that you pay premiums while you are receiving benefits. If, or when your disability ends, you must begin making premium payments again to maintain coverage.

The waiver usually applies retroactively to the beginning of your disability. If you made your premium payments while the waiver was in effect, those premiums are usually refunded. To protect your financial interest, you should continue to make premium payments until the insurance company has advised you in writing that you are on waiver. The insurance company will refund the payments if the waiver period is retroactive.

What Happens If the Insurance Company Denies My Life or Disability Claim?

There are several issues that can arise if an insurance company denies a disability insurance claim based on non-payment of premiums because the insured thought that the waiver of premiums was in effect.

How the provision functions vary by contract, and the definition of disability varies.

Most often you are considered totally disabled if you can’t perform the material and substantial duties of an occupation for which you are qualified by education, training or experience. The disability must be caused by an injury or sickness.  If your injury or sickness prevents you from being able to perform your job responsibilities and related duties, you will probably be considered disabled.

4 Ways a Disability Attorney Can Help If You Have Waiver of Premium Issues

  1. Explaining the key terms under the insurance policy.
  2. Explaining the law regarding waiver of premium.
  3. Assisting you in explaining to the insurance company why you qualify for waiver of premium
  4. Filing a lawsuit if warranted if the insurance company has unlawfully fulfilled its obligations under the insurance policy.

We can help. Contact us today for a complimentary assessment of your long-term disability claim.

Contact Us

Contact Form

  • This field is for validation purposes and should be left unchanged.