Legal Question in Insurance Law in California

I have Employee Term Life Coverage through employer and I was deemed disable by the state of California due to Bipolar disorder and Lupus. So I am getting my SS but was declined by group life coverage but the policy clearly states total and permanent disability . I want to fight this denial and wanted to know if this is the type of case an insurance attorney would take.

thank-you


Asked on 8/28/09, 11:51 am

1 Answer from Attorneys

Gerry Goldsholle Advocate Law Group P.C.

Based on the short blurb in your posting I am not sure exactly what you are asking, or what group life insurance or other benefit you were turned down for.

If you are suggesting that the death benefit under a life insurance policy should be paid based on a finding by Social Security that you are totally and permanently disabled, that is not the way life insurance works.

Although many life insurance policies provide for a waiver of the premiums you would otherwise have to pay to keep the life policy in force if you are totally and permanently disabled, the finding by Social Security while somewhat persuasive, is not necessarily binding on a life or disability insurance company and the standards used may be different.

As the case involves employer sponsored or provided group life insurance, it is highly likely that your rights would be governed by ERISA (unless your employer is a governmental unit or religious organization), a Federal Law originally passed in 1974.

You may wish to call our law firm's Irvine office at 888-ITS LEGAL (888-487-5342) to briefly discuss the matter, without cost or obligation, and determine if we or a firm in the Advocate Law Law Group P.C. Network that does ERISA work might be willing take you on as a client.

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Answered on 8/28/09, 2:20 pm


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