Long Term Disability Insurance Claims Managed by Sedgwick Busier Than Usual
Monday, December 2nd, 2019
Disability lawyers Justin Frankel and Jason Newfield keep a careful eye on the calls and emails that we receive in the office. We are a hands-on practice, so we are very aware when one insurance company or another starts sticking it to people who have filed for disability claims.
It seems particularly cruel as we move into the holiday season for a company to start sending out denial of claims and terminations of claims letters, but we have noticed an uptick in the number of calls we’re receiving from people whose disability insurance claims are managed by Sedgwick Claims Management Services.
Is Sedgwick a Disability Insurance Company?
Sedgwick Claims Management Services, also known as Sedgwick CMS, is a large third-party administrator that is hired by self-insured companies to administer their insurance policies, including disability insurance.
If you aren’t familiar with how self-insurance works, here’s a quick lesson. For large multi-national corporations, where there are hundreds of thousands of employees, it often makes more financial sense for the company to self-insure rather than purchase insurance from an outside company. But the company is not in the business of managing claims, so it contracts that task to an outside company. But it only makes financial sense if the claims “experience” is kept low – meaning they do not pay claims.
Sedgwick has a number of disability lawsuits where even the judges were displeased with the tactics used by the company. You can read more about these cases here.
Frankel and Newfield Partners Work with Clients to Protect their Claims
Our law firm is very different than most in this area of the law. When you work with Frankel & Newfield, you work with Justin Frankel or Jason Newfield. We believe that your claim is too important to be handled by anyone but an attorney who has extensive experience with disability cases. This is especially true when it comes to claims that are being managed by Sedgwick.
Our process starts with a conversation with you and a partner’s review of certain critical documents. We have to see what your policy promises, and usually we ask to see some of your medical records. Not only will you receive a complementary review of your case, you’ll also receive an honest evaluation. We have worked in this area for decades and we are able to look at long term disability insurance policies and medical records from several different perspectives: the insurance company, the administrative judge and the federal court judge.
If you are currently on short-term disability and have not been paid, the question we are gong to ask is simply this: are you planning to return to work? Our skill set is geared towards individuals who are not able to return to work and are struggling to resolve their short term disability claim so they can move into long-term disability benefit
Often, a disability insurance company or third party administrator like Sedgwick will deny or delay a short term claim because they anticipate that the person will not be able to return to work, so denying or delaying a short term claim will also delay the long-term disability claim.
We believe that the reason, frankly, is all about the money. A person who is young and has many years of disability payments ahead of them presents significant financial exposure for a self-insured company. For a person who is not so young but whose disability benefits are high, the financial cost of accepting a claim is also high. It costs less to lose the medical records, understaff a call center and ignore the endless complaints and poor reviews.
How Can You Protect Your Claim From Sedgwick Tactics?
Once you learn that your disability claim is going to be administered by Sedgwick, our advice is to contact our office as soon as possible. Call us at 877-583-2524 to begin a conversation about your status and how we can help.
One thing that is important for you to know: if you are not being seen by a treating physician, or if you are being seen by a general physician who does not have special training or credentials in your specific illness or disability, Sedgwick (or any insurance company) will question your medical reports. If a general practitioner told you six months ago that you should go out on disability and you have not had any medical care since then, expect your claim to be challenged.
We have had cases where people with rare diseases were being treated by leading specialists in their field and insurance company attorneys challenged the medical treatment and doctor selection. When it comes to a disability claim, there needs to be an airtight defense, at every step of the way.
Call Frankel & Newfield If Your Claim is Being Mistreated by Sedgwick
If you have already been denied or if benefits have been terminated, you should immediately contact the disability insurance law firm of Frankel & Newfield. We have represented many people against Sedgwick and know how the company works to minimize paying out claims for its big company clients. Call our office at 877-583-2524 and learn how we can help you.