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Clients always want to know what their case is worth, and although case evaluation can be a complex process, there are specific factors that can provide considerable guidance in this.
One of the most important components in case evaluation has to do with the merits of your claim: How clear is your disability? Is there universal agreement among treating physicians as to your diagnosis and prognosis? Are you on prescription medications due to your medical condition? If so, what are the side effects from those medications? What is the specific occupation for which you have disability insurance, and how does your disability prevent you from performing any of your substantial and material job duties?
Another important factor in evaluating your case has to do with the specific terms of your policy. Is your policy an “any occupation,” “own occupation,” or a hybrid policy with components of both?
A third critical factor is which State has jurisdiction over your claim. Bad faith protections and remedies are strongest in states such as California, Nevada, New Mexico, Arizona, Oregon, Florida, and a handful of others. In some states (such as Massachusetts, New York, and Connecticut), insurance companies are protected a lot more than policyholders and your protections as a claimant are severely limited.
Fourth, are you ERISA-pre-empted? ERISA is the black hole of policyholder protections. If you obtained your policy in the workplace, then unless you work for the State or Federal government or a religious organization, you may have close to no rights at all. A policyholder can literally lose their home, their life savings, and be driven into bankruptcy by an insurance company that is flat-out defrauding them out of their benefits and yet not have the right to recover a dime for any of these losses. An ERISA claimant also has no right to a jury trial. ERISA literally grants insurance companies immunity from even the most criminal behavior.
There are a multitude of other factors—pro and con—and the strategies involved with the case evaluation process are of great importance to the eventual outcome. During our Free Case Evaluation we will consider how these factors may affect the potential outcome and result of your case.
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