Berkshire Insurance Company Claim Denials Attorney
Experienced Guardian Insurance Company Claim Denial Lawyers
The Guardian Life Insurance Company of America is a Fortune 500 business focused on marketing health, life and disability insurance, retirement services and investment products to businesses and individuals. The company delivers its products and services through employee benefit programs and directly to individuals and businesses. Millions of participants in group plans and individual policyholders rely on Guardian or Berkshire coverage. To help you navigate these coverages, our Berkshire Insurance Company Claim Denials Attorney is here to help.
Guardian and The Berkshire Life Insurance Company completed a merger in 2001, combining two major players in own-occupation disability insurance and certain other insurance sectors. The merged company puts a strong marketing emphasis on “income protection” and disability insurance for white-collar professionals, provided under brand names such as Provider Plus.
Allegations Of Wrongful Claim Denials, Benefit Terminations, And Delays
Like other disability and life insurance companies, Guardian and Berkshire have faced extensive litigation involving unfair handling of claims. If you or a family member were affected by this, it’s important to contact a Berkshire Insurance Company Claim Denials Attorney to get justice. Actionable practices often involve the use of biased and unqualified medical evidence to deny or terminate claims, retroactive cancellation or “rescission” of coverage, excessive benefit payment delays and more.
Proving You Have a Disability Claim
What counts as a disability depends on your insurance plan. Some plans say you’re disabled if you can’t do your job because of illness or injury, while others say you’re disabled if you can’t do any job that fits your skills, education, and experience. Some plans start by covering you if you can’t do your job, and later change to covering you if you can’t do any job you’re qualified for.
A Track Record Of Success In Litigation Against Guardian Life
At Pillsbury & Coleman, LLP, our dedicated lawyers have achieved positive results for thousands of insurance policyholders, both through federal ERISA appeals and litigation and lawsuits filed in California state courts. Our recent victories in cases involving The Guardian Life Insurance Company include obtaining:
- A seven-figure settlement on behalf of an obstetrician whose orthopedic condition prevented him from performing deliveries and other surgical procedures, but who was denied benefits based on Guardian’s assessment that he was not disabled under the policy definition
- A trial court verdict and order restoring disability benefits and paying back benefits plus attorney fees for a client suffering from the painful and disabling condition thoracic outlet syndrome, based on our demonstration that Guardian failed to properly consider medical evidence
Steps to Take After a Claim Denial from MetLife
If Berkshire Insurance Company denies your claim in California, follow these steps:
- Review the Denial Letter: Understand the specific reasons for denial and compare them with your policy coverage.
- Gather Documentation: Collect all relevant documents, including your policy, correspondence, and evidence supporting your claim.
- Contact Berkshire for Clarification: Discuss the denial with Berkshire Insurance and take detailed notes of the conversation.
- Consult Pillsbury & Coleman, LLP: Contact the law firm Pillsbury & Coleman, LLP for legal advice and assistance in appealing the denial.
Berkshire/Guardian Life typically handles claim denials through a structured process that includes a detailed review of the submitted claim and supporting documentation. If they determine that the claim does not meet the policy’s coverage criteria or falls under an exclusion, they will issue a denial letter to the policyholder. This letter outlines the specific reasons for the denial, referencing the relevant policy provisions or exclusions.
The company often requires extensive documentation to support claims and may request additional information if the initial submission is deemed insufficient. They may also involve medical or vocational experts to evaluate the validity of claims, especially for disability or health-related cases. Once a denial is issued, policyholders have the right to appeal the decision. The appeal process generally involves submitting additional evidence and a formal written argument explaining why the denial was incorrect based on the policy terms.
Berkshire/Guardian Life is known to adhere strictly to policy language and procedural requirements, which can make the appeal process challenging without legal assistance. Therefore, it’s advisable for policyholders to consult with an attorney, such as those at Pillsbury & Coleman, LLP, to navigate the complexities of the appeals process effectively.
Contact a Berkshire Insurance Company Claim Denials Attorney
Pillsbury & Coleman’s attorneys are well-equipped to pursue all types of valid claims against insurance companies that engage in unfair practices and wrongfully deny benefits. If you are facing an LTD claim denial or other problems with Guardian or Berkshire insurance, please call our San Francisco office at (415) 433-8000 or contact us for a free case evaluation.