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What You Shouldn’t Say to Insurance Adjusters

Posted on: January 31st, 2022 by Timothy Hendershot
Insurance adjusters are trained to appear friendly, but remember, they aren’t on your side.

Insurance adjusters are trained to appear friendly, but remember, they aren’t on your side.

An insurance company pays a claims adjuster to evaluate claims and establish the insurer’s potential obligation. You should never trust that an insurance adjuster is on your side, even if they appear kind and really concerned about your health and well-being.

The adjuster will, in most circumstances, be deliberately working against you. Insurance adjusters are taught to engage in informal conversations with victims in order to elicit adverse information about their cases. Remember that they work for the insurance company, and their primary purpose is to save money for the company by paying you as little as possible.

You must be extremely careful about what information you share with an insurance adjuster. Say as little as possible. Better still refer all communications to an attorney.

Schedule a free consultation at Cunnane Law in Edmonds WA to discuss your situation. Call or contact us online now.

What You Can Say to an Adjuster

You should not say anything to a claim adjuster or anyone else if you have already hired an attorney. Simply refer them to your legal counsel.

If you don’t already have an attorney, you can provide an insurance adjuster with basic information like your name, address, and phone number. We advise against providing any additional information about yourself, such as your employment status.

Limit the amount of information you share about the accident as well. It is acceptable to provide an adjuster with the time, date, and location of an accident, as well as details about the vehicles involved and any possible witness contact information.

Do not go into detail about how the accident occurred. Even if pressed, refuse to provide a written or recorded statement about the accident.

What Not to Say to an Adjuster

Never admit any kind of wrongdoing or say you’re sorry. Remember that a claims adjuster is looking for reasons to reduce an insurance company’s liability, and any admission of negligence can seriously jeopardize a claim.

Do not say you feel fine, or better than you did, (this is especially important when answering the common first question, “How are you?”). Never mention your current health situation.

Do not speculate about any injuries you believe you may have sustained. If your actual diagnosis is more serious than your self-diagnosis, your statement may present a problem.

Refuse any request by insurance adjusters to make a recorded statement. A recorded statement can sabotage your case.

What Are Insurance Adjusters Looking For?

The primary concern of many insurance adjusters is ensuring that a claim is not fraudulent. In most cases, an adjuster will conduct a physical examination of the vehicles involved.

The adjuster may contact medical providers to determine not only the costs of your medical care, but also whether previous injuries could be used to reduce the value of your current claim.

How Do Personal Injury Adjusters Determine Compensation?

If an insurance adjuster believes liability is clear after conducting an investigation, they may offer the victim a settlement. In almost every case, this initial amount is significantly less than what a victim may be entitled to.

Lowball offers are made in order to close the cases of the most desperate victims as quickly as possible. In more serious accidents, the adjuster may offer a larger sum, but it will still be potentially less than they could receive if they hired a lawyer.

Allow Our Law Firm to Help

For the past 23 years, Cunnane Law has assisted injured people all over Seattle and western Washington in dealing with insurance companies. An experienced lawyer could be extremely beneficial in ensuring that you do not accidentally say anything that jeopardizes your claim. We are aware of their tricks and can assist you in avoiding being taken advantage of. Set up a free consultation by calling or contacting us online.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

Mistakes Many Plaintiffs Make in Personal Injury Cases

Posted on: January 28th, 2022 by Timothy Hendershot
Don’t make a painful situation worse. Avoid these mistakes in your personal injury case.

Don’t make a painful situation worse. Avoid these mistakes in your personal injury case.

A fact of the law is that every case is unique. Each personal injury case has its advantages and disadvantages. However, some of the shortcomings can be avoided.

At Cunnane Law in Edmonds, WA, we see clients make mistakes all the time and that’s perfectly fine. Nobody can claim to be faultless. However, many blunders may be avoided if people just understand how the law works and the ramifications of their own actions (or lack of action).

We believe that by knowing some of these pitfalls, personal injury claimants will be able to avoid them and strengthen their claims, allowing them to receive the compensation they deserve.

1st Mistake: Making Things Up, Guessing and Lying

Lying, speculating, and making things up (particularly under oath during a discovery investigation on the stand during a trial) are all cardinal sins! A Plaintiff’s credibility and likeability will be entirely ruined as a result of this. Nobody believes a liar or someone who fabricates evidence. If a Plaintiff does not know or cannot recall the answer to a question, all they have to do is declare “I don’t know” or “I don’t remember.” That is all there is to it. It’s fine to say you don’t remember something.

2nd Mistake: Delay in Reporting by a Plaintiff and Inaction are Case Killers

Benefits from the insurance company don’t just fall from the sky. In order for a Plaintiff or Long-Term Disability Benefit to get the compensation which they deserve, they need to take action! The Plaintiff must report the accident to the police, and to their insurance company. See a doctor to record their injuries and follow the treatment plan. Also fill out benefit forms, and contact a personal injury lawyer. If a Plaintiff simply sits in bed or stays at home all day and does not reach out for help; then they will get nothing.

3rd Mistake: Failing to Seek Regular Medical Attention

The Plaintiff has the responsibility of proving his or her claims in a personal injury case. That means the Plaintiff must show that he or she is disabled or injured to the Judge and Jury. It is not enough for a Plaintiff to testify that they have been injured or incapacitated. This is self-serving, uncorroborated evidence that will be dismissed in trial.

A Plaintiff will need specialists, therapists, and treating doctors to state that the Plaintiff is injured in order to have a successful personal injury or long-term disability case. It is extremely beneficial to have a doctor/therapist with no stake in the outcome corroborate a Plaintiff’s pain and suffering. In a personal injury case, demonstrating that a plaintiff is receiving regular medical attention/treatment is also very useful. It helps debunk the insurer’s standard argument that a Plaintiff has failed to reduce his or her damages. It also shows a pattern in which, despite receiving regular treatment, the Plaintiff is still injured and that those injuries/disabilities are affecting his or her life.

4th Mistake:  Assuming that the Insurance Company Has Your Best Interests at Heart.

Do not for one moment believe that the insurance company will send a Plaintiff to doctors or service providers who are looking out for his or her best interests. They don’t work that way.

Insurance Medical Examinations are intended to create a paper trail to justify an insurance company’s claim that the Plaintiff/Disability Claimant is not as disabled or as injured as they make themselves out to be.

We Can Help with Your Personal Injury Case

Cunnane Law has extensive experience in personal injury cases for people all over the Puget Sound and Seattle area. To get the help you need, contact us today.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

New Year’s Resolutions for 2022

Posted on: December 27th, 2021 by Timothy Hendershot
Do what you can to stay safe from car accidents and lessen the risks of driving.

Do what you can to stay safe from car accidents and lessen the risks of driving.

Car accidents in Edmonds, Washington happen all the time, and they can leave drivers and passengers with serious, sometimes life-threatening injuries. While other drivers’ carelessness is frequently to blame, there are steps you should take to lessen your risks. Cunnane Law recommends the following New Year’s resolutions for 2022 that will assist you and your passengers stay safe.

Reducing Your Odds of Car Accident Injuries in Edmonds

Even a relatively minor collision can result in medical bills in the hundreds of thousands of dollars, while a more serious collision might result in permanent disabilities. Make it a point to follow these six guidelines to lessen your chances of being injured in a car accident in Edmonds WA:

1. Have your car serviced on a regular basis.

Tire blowouts, braking failures, engine problems, and other mishaps that raise your chance of a car accident can all be avoided with regular vehicle maintenance.

2. Be aware of health conditions that may impact your driving ability.

Poor vision is a serious issue that can raise the danger of a car accident, especially when driving at night. If you use glasses, have your eyesight checked on a regular basis and consider investing in anti-glare lenses. In terms of your overall health, talk to your doctor about any medical ailments you have or drugs you’re taking that can affect your driving ability.

3. Steer clear of unsafe driving behaviors.

Avoiding unsafe driving behaviors is one of the simplest methods to lower your chances of being involved in a car accident. According to the National Highway Traffic Safety Administration (NHTSA), speeding or driving too fast for the conditions, ignoring traffic signs or signals, and driving while intoxicated are among the major causes of potentially serious vehicle accident injuries.

4. Remain calm when driving.

Tailgating, incorrect passing, and failure to yield are all aggressive driving practices that raise your crash risk. Maintain a calm demeanor while driving to avoid competing with or becoming frustrated by other drivers.

5. Give driving your full attention.

While many of us are proud of our ability to multitask, driving demands your undivided concentration. Avoid talking on the phone, texting, changing your GPS settings, changing your appearance, or any other activity that draws your attention away from the road while driving.

6. Wear a seatbelt.

One of the easiest things you can do to lessen the risk of automobile accident injury is to make it a priority to wear your seatbelt at all times while in your vehicle and to require your passengers to do the same.

Allow Us to Assist You Today

Cunnane Law Office is a personal injury law firm dedicated to assisting accident victims in Washington State, whether they were injured in an automobile accident, at work, in a fall, by a healthcare professional, or in any other event caused by someone else’s negligence.

Unfortunately, many injury victims discover that their insurance company refuses to pay all or even any of their medical bills following an event that was not their fault. We’re here to tell you that you’re entitled to compensation for not only your medical expenditures, but also any lost earnings and pain and suffering, and we’re here to make sure you get it. Contact us today.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

It Won’t be a Merry Christmas for Those Affected by These Weird Holiday Injuries

Posted on: December 14th, 2021 by Timothy Hendershot
Don’t let anything ruin your holiday season! Watch out for these weird holiday injuries.

Don’t let anything ruin your holiday season! Watch out for these weird holiday injuries.

It’s not only about decorating the halls, trimming the tree, and exchanging gifts during the Christmas season. It’s also a time when, no matter how much joy is spread, serious injuries can still occur.

The weirdness of the causes of these vacation injuries is what jumps out the most. While these injuries may not be as dramatic as Santa being injured while falling down the chimney or elves filing workers’ compensation claims after being injured while constructing toys, some of the real-life incidents that have been reported are equally as bizarre.

Christmas Lights: Cheerful, Bright, and… Dangerous?

Hundreds of individuals are injured every year in accidents involving Christmas lights. That’s right, you read it accurately. Hundreds. According to the most recent USCPSC report, there were approximately 150 injuries in the 40-65 age bracket alone.

If you’ve ever seen a movie in which a character falls while installing Christmas lights on the roof, you’ve witnessed something that happens every year in real life. Unfortunately, such falls in real life result in genuine harm, not laughs.

Electrical injuries are also caused by Christmas lights, such as when people are shocked owing to defective wiring or when they are caught in an inopportune combination of electricity from the lights and melting snow. Fires produced by improper wiring on Christmas light strings are also common causes of burns.

Trimming the Tree with Care

Every year, Christmas trees cause a number of accidents and illnesses, and not simply the types of injuries you’d expect, such as cuts from chopping down a real tree.

People have experienced allergic reactions to trees they have placed in their homes. In other cases, people have had their eyes damaged when they bumped into Christmas trees.

Are you in the mood to dance? Maybe you might want to consider sitting still.

People have also blamed their injuries on Christmas music and the holiday spirit. One man said that he had severe joint pain as a result of his excessive dancing at a Christmas party. In another case, an 80-year-old woman said she heard Christmas music and tried to get out of her recliner to dance, but she damaged herself by “shaking her hips.”

Carpal Tunnel Syndrome and Christmas Cards?

In 2014, one of the oddest Christmas-related injuries of all time occurred. After writing an excessive amount of Christmas cards, a person claimed he suffered carpal tunnel syndrome.

We sincerely hope you never fall victim to these holiday injuries, or any others! We want nothing but the best for all our Edmonds and Seattle-area friends throughout the season. If you need any help with a personal injury case, you know who to contact. From all of us at Cunnane Law, have a safe holiday season and a Merry Christmas!

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.


Note: The injuries listed above are from the National Electronic Injury Surveillance System (NEISS) of the United States Consumer Product Safety Commission (USCPSC).

Be Thankful for These Five Things

Posted on: November 19th, 2021 by Timothy Hendershot
We wish all of you in Edmonds, Seattle, and beyond a Happy Thanksgiving.

We wish all of you in Edmonds, Seattle, and beyond a Happy Thanksgiving.

At this time of year, you may have a lot to be thankful for. Even if you have suffered a severe loss or other hardship this year, you can find comfort in giving thanks for what you do have and what you can expect in the following year.

Cunnane Law of Edmonds’ personal injury lawyers would like to wish you a happy and safe Thanksgiving holiday and share with you the following list of five things for which we believe we may all be thankful this holiday:

1. Spending Thanksgiving with family and friends in a safe environment.

Many factors contribute to a safe Thanksgiving. The first factor is the host’s home. It should be well-lit, clean, and free of potential risks like frayed wires or damaged steps. Before the guests arrive, any hazardous situations should be repaired or removed.

Another factor of a safe vacation is ensuring that all visitors arrive and depart safely. If there will be alcohol served at your Thanksgiving gathering, assign someone to drive guests’ home or offer them the option of staying the night.

2. A deliciously prepared holiday meal free of burns, mishaps, or personal injury.

Thanksgiving also emphasizes the importance of kitchen safety. Delegate kitchen activities to avoid burns and cuts by keeping the space from becoming overcrowded. To protect them as well as the people making the meal, keep children and pets out of the kitchen.

Food poisoning prevention is an important part of food safety. People should avoid cross-contamination by using different utensils and cutting boards for each dish. Any leftovers should be packaged and stored in the refrigerator as soon as possible after the dinner is over.

Also, before serving, keep a close eye on the internal temperature of your turkey. Cook the turkey to 165 degrees Fahrenheit to avoid foodborne illness.

3. Enjoying a stress-free, easy Thanksgiving break.

The days are getting shorter, and the temperature is getting cooler as we get deeper into the fall season. When these circumstances are combined with the significant increase of drivers on the road during the holiday season, you and your passengers are at a greater risk of getting injured in a car accident than at other times of the year.

Check your vehicle’s fluid levels and tire pressure before heading out on your Thanksgiving road trip. In case you become stranded or someone becomes injured, bring a safety kit with you that includes a basic tool set, a warm blanket, a flashlight, and first-aid supplies. Follow the rules of the road and adapt your driving to your surroundings to reduce your chances of getting involved in an accident.

4. Parades and other festivities on Thanksgiving Day

Thanksgiving can be a lot of fun for the whole family, with local and televised parades, football games, and family traditions. Remember these times because, while they may be traditions, the unique recollections of each year will never be replicated.

5. A personal injury attorney in Edmonds who is ready to assist if something goes wrong.

Know that our team at Cunnane Law is here to help you if you’ve been injured in an accident. We have more than 25 years of legal experience to pursue your claim for compensation if you have been seriously injured in a car accident.

We will meet with you to review your situation and, if a claim is possible, we will pursue the highest possible financial recovery. For a free consultation to discuss your case contact Cunnane Law in Edmonds, WA today.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

Stay Safe This Fall and Winter

Posted on: November 17th, 2021 by Timothy Hendershot
It’s cold, it’s wet, it’s Seattle in fall and winter. Stay safe!

It’s cold, it’s wet, it’s Seattle in fall and winter. Stay safe!

Fall and winter are wonderful seasons in Edmonds and the surrounding Seattle area. However, the wet and cold weather can sometimes lead to hazards and potential injuries. To help keep you safe this fall and winter, the personal injury experts at Cunnane Law want to share some helpful tips.

Be Prepared for Snow

Yes, it does snow in Seattle! While the snow is unlikely to linger around for long, it does make the roadways much more dangerous. That’s why the Washington State Department of Transportation urges everyone to prepare ahead of time by packing your car with everything you’ll need if you get stuck, including water, gloves, a blanket, tire chains, and ice scrapers. Drivers are also encouraged to drive appropriately for the weather, slow down, and leave plenty of space between your car and other vehicles. During the winter, slick roads, snow shoveling, and the risk of frostbite are ever-present danger.

Remember:

  • In the snow, drive carefully and avoid driving when the road conditions are very treacherous, and visibility is poor.
  • If you’re shoveling snow or going outside for any other reason, be aware of the risk of frostbite and take frequent breaks to keep your body temperature from dropping too low.

Carbon Monoxide Hazard

Carbon monoxide poisoning is most prevalent in December and January. During the winter, more fuel-heating appliances are used, and individuals are more inclined to start their automobiles in the garage to warm them up before going out into the cold, making Carbon monoxide poisoning more likely.

Those people who heat their homes with oil, propane, or natural gas should make sure their heating system is cleaned. If you don’t do so, carbon monoxide could creep into your home. Similarly, if you start your car in the garage to warm it up before leaving, make sure a window or door to the outside is open to let the fumes out.

We advise Washington State residents to purchase a CO detector to warn them if there is a CO leak in their home. And, of course, remember to replace the battery in your CO detector.

Slippery Conditions and Hot Water

Thousands of Americans are injured each year as a result of slip and fall accidents. Because of the slick, icy sidewalks and roadways, there is a heightened risk throughout the winter months. But there’s also another danger lurking within your house: bathtubs and showers. The appeal of a hot bath or shower is as strong as ever during the winter months. Moreover, it is as hazardous as ever: scalding or overly hot tap water causes at least 3,800 injuries each year. These mishaps are particularly risky for children under the age of five as well as the elderly.

Remember:

  • When walking outside in areas where ice or slippery conditions may persist, use adequate footwear with non-skid soles.
  • Reduce your chance of hot water burns by setting your hot water heater’s temperature to 120°F or lower.

Have You Been Injured?

An injury can occur in any of the situations listed above as a result of your own negligence, but it can also occur as a result of someone else’s negligence. For example, the carbon monoxide monitor you just got may not work correctly due to design flaws. Or perhaps a neighbor may not have cleared ice as thoroughly as he or she should have, causing you to slip and fall.

If you have suffered a personal injury in Washington State due to circumstances beyond your control, consider speaking with an Edmonds personal injury attorney to about your case. To discuss the details of your accident and injuries, contact Cunnane Law personal injury attorneys online or by phone immediately.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

Personal Injury Cases are Scary! You Need a Good Lawyer

Posted on: October 28th, 2021 by Timothy Hendershot
Don’t be scared. We’re here to help you win your personal injury case.

Don’t be scared. We’re here to help you win your personal injury case.

It’s scary and distressing when you or a loved one gets injured in an accident. Your focus needs to be on yourself or a loved one’s recovery from injuries. You need to allow Cunnane Law’s personal injury lawyers in Edmonds make that situation less scary and difficult.

What’s So Scary About a Personal Injury Case?

The majority of organizations and individuals are covered by insurance against bodily injury claims. Insurance companies have a lot of expertise investigating claims against their policyholders and a lot of resources at their disposal to use against you. They frequently try to exploit accident victims who do not have access to legal representation. Cunnane Law can assist you in defending yourself as well as a loved one who has been injured.

The law imposes time limits on how long you or a loved one has to bring a lawsuit after an accident, and it may also require you to complete specific steps prior to filing a lawsuit. To verify some claims, the law also demands certain types of evidence. Before bringing a lawsuit, it is sometimes necessary to take precautions to preserve evidence. Edmonds WA personal injury lawyers are familiar with these regulations as well as how to investigate and develop your personal injury case.

Many people’s first encounter with the legal system will be a personal injury case. Because we have successfully handled personal injury cases every day for over twenty-five years, Cunnane Law can help you to understand the system and navigate it.

What makes things even more difficult is having to fight an insurance company in order to get the care you or a loved one deserves. Cunnane Law’s personal injury lawyers in Edmonds, WA know how to get their clients the support they need.

So Don’t Be Frightened! Call for Help at 425-672-7100

Personal injury lawsuits can be scary. Don’t complicate the situation by going it alone. Allow Cunnane Law to assist you so that you can concentrate on your life and your loved one.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

Long-Term Disability Definitions, Part 2

Posted on: October 19th, 2021 by Timothy Hendershot

In our last blog we listed long-term disability definitions from A – L. Here are some more definitions to help you understand the terminology used by insurers in your long-term disability policy.

M

Material Duty (or Duties) – Material duties are defined as the set of tasks or abilities required for your particular occupation. These are duties that cannot be omitted or changed without jeopardizing your ability to perform your job. Small differences in material duties can have a significant impact on whether you qualify for disability benefits.

Maximum Capacity – The full utilization of the employee’s abilities in any occupation that he or she is capable of performing.

Maximum Monthly Benefit – The highest payment under the Long-Term Disability plan, a disabled employee can receive monthly.

Mental Health Limitation – Benefits for mental health conditions such as depression, anxiety or bipolar disorder will only be paid for 24 months.

N

Non-contributory Plan – a group coverage plan in which the employee does not contribute, and the employer pays the entire premium.

Non-Exertional Limitations – Non-exertional limitations include fatigue, intellectual and cognitive limitations, headache, memory loss and medication side effects.

O

Offset – Payments or benefits received by the claimant from a third party that reduce the amount of long-term disability benefit payable, including settlements from lawsuits, Social Security disability, certain retirement disability benefits, Workers’ Compensation, and certain state disability benefits.

Own occupation – A claimant needs to be unable to perform their “own occupation” that they have been trained to perform for the first 24 months or as defined in the policy.

P

Plaintiff – a person who opens a lawsuit in a court of law.

Policy / Contract – A legal agreement between a person or a group and an insurance company listing all the details of the plan’s coverage.

Policyholder / Contract Holder – A person or group who purchases an insurance plan from an insurer.

Pre-existing Condition – a medical condition for which a person has received medical care prior to the effective date of the policy.

Punitive Damages – A money award that the injured plaintiff receives when the insurance company has been found to engage in fraudulent, oppressive or malicious behavior.

R

Rate of Benefit – The percentage of income to be replaced by the disability plan.

Residual Disability – If you are physically unable to perform some, but not all, of your regular job functions because of sickness or injury.

Residual Functional Capacity (RFC) – A claimant’s RFC is based on the level of work a person can physically perform. The levels are sedentary, light, medium, heavy and very heavy.

S

Salary Percentage Requirement – The insurance company is required to find occupations that pay at least 80% of the claimant’s pre-disability income.

Schedule of Benefits and Exclusions – The section of the disability insurance policy that describes what the policy covers and what it does not cover.

Self-reported Symptoms Limitation – Some policies have a provision that limits coverage (often for two years) for disability benefits based on self-reported symptoms such as Chronic Pain, Chronic Fatigue Syndrome and Fibromyalgia.

Statute of Limitations – A legal provision which sets a time limit for initiating legal proceedings.

U

Underwriter – The responsible company that receives the insurance premiums and carries out the policy contract.

V

Vocational Expert Opinions –A vocational expert forms an expert opinion on what jobs a claimant may be able to perform taking into account all restrictions and limitations caused by the impairment, as well as age, education, background, work experience and skills.

W

Waiver of Premium – Individuals who become disabled and qualify for benefits are not required to pay any additional disability premiums during the period that benefits are being paid out.

Need Help with Long-Term Disability?

Talk to us at Cunnane Law today about your claim. We are ready to assist you if you have been denied long-term disability benefits. It is critical that you understand the terms of your policy as well as the law.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

Long-Term Disability Definitions, Part 1

Posted on: September 21st, 2021 by Timothy Hendershot

If you have a disability claim, you’re already at a disadvantage attempting to decipher 90% of the material you’re now required to read, comprehend, and answer to. A glossary is required to make sense of the provisions of your long-term disability policy. This list of definitions of disability insurance terms will assist you.

A

Active Full-Time Employee – A full-time employee who works a regular workweek for a company is known as an active full-time employee.

Active Work Requirement – To be eligible for disability benefits, you must be working at least the minimum number of hours per week as described in your company’s policy.

Activities of Daily Living (ADLs) – Routine activities that people do on a daily basis without assistance. Eating, bathing, dressing, toileting, walking, and continence are the six basic ADLs.

Adjuster – An insurance company employee or subcontractor who investigates insurance claims and determines how much the insurer must pay for a submitted claim.

Attending Physician Statement – A medical report written by the insured’s doctor that details his or her medical history, both past and present.

B

Bad Faith – Insurance companies are legally bound by a “covenant of good faith and fair dealing.” When an insurer breaks this covenant by delaying or denying payments in an unreasonable manner, it is considered to be acting in bad faith.

Beneficiary – The person or entity authorized to receive the proceeds or benefits of an insurance policy.

C

Catastrophic Disability – A claimant is so severely disabled by an accident or disease that he or she need assistance with even the most basic tasks of daily living, such as feeding, dressing, or showering.

Claim – A payment request made under a disability insurance policy.

Contributory Plan – A group insurance plan in which a company and its employees split the costs.

D

Deductible – A stipulation in a disability insurance policy requiring the policyholder to pay an initial amount of expenses before the disability insurance coverage begins.

Disability – The criteria used by the insurance company to evaluate if you are disabled and entitled to benefits.

Disability Appeal – If your claim is denied, you have the right to appeal and legally challenge the denial in a court of law.

E

Effective Date – The day the insurance policy starts.

ERISA – ERISA (Employee Retirement Income Security Act of 1974) is a federal law that regulates the handling of Employee Benefit Plans.

Exclusions – Specific conditions under which a disability will not be covered are outlined in disability policies.

F

Functional Capacity Exam (FCE) – A series of physical tests to see if a claimant can return to work.

G

Group Coverage – Individuals can get group long-term disability coverage through their company, a professional group, or an association.

I

Individual Disability Insurance (IDI) – Disability insurance for individuals can be acquired directly from an insurance broker. The individual is responsible for all costs.

Insured – A person or organization covered by insurance.

L

Long Term Disability Insurance – Long-term disability (LTD) insurance provides monthly benefits (income replacement) if a person is unable to work for more than two years due to illness or injury.

Lump-Sum Payment – Disability benefits are usually paid in a lump-sum on the day after the Elimination Period expires.

Your Long-Term Disability Experts

At Cunnane Law, we are highly experienced in assisting people with their long-term disability claims. Our lawyers work tirelessly to represent you and your interests in your dealings with insurance companies. You need all the facts, all the information, and all the help you can get. We’ll be publishing Part 2 of this guide soon, but in the meantime, if you have questions, contact us. We work with clients in Edmonds, Shoreline, and all across the greater Seattle and western Washington area.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

When Should I Seek the Advice of a Disability Insurance Attorney?

Posted on: September 15th, 2021 by Timothy Hendershot
Our clients can relax knowing that the attorneys at Cunnane Law are in charge of their disability claim.

Our clients can relax knowing that the attorneys at Cunnane Law are in charge of their disability claim.

You may hear a lot of contradictory opinions as to whether you need a lawyer as you prepare to file a disability insurance claim. While you may be tempted to put off engaging an attorney, it is usually to your best advantage to speak with one before filing a disability claim, rather than afterward.

You can make or break your disability claim based on your administrative record.

The Employee Retirement Income Security Act of 1974 (ERISA), governs your claim if you file for employer-sponsored disability benefits. You have a limited amount of time under ERISA to submit supporting evidence for your claim.

Once the insurance company has issued a final decision on your claim, the courts will only review the information contained in your “administrative record,” which consists of plan documents, previously submitted proof, and other information that was available to the insurance company. In most cases, the court will not consider fresh evidence, no matter how crucial or relevant it may be.

Unfortunately, we frequently meet with disabled people after their decisions have been made. Many times, vital evidence that might improve their claims is missing from their administrative records—but it’s too late to present it.

If you consult with an expert disability lawyer at Cunnane Law from the start, we’ll carefully evaluate your administrative record and enhance it with material that advances your disability claims. This “data stacking” should place you in the greatest possible position to win your case.

ERISA plans have a lot of complicated terms and conditions.

It’s usually a good idea to read the Plan Document before filing a disability insurance claim. This document outlines the terms, restrictions, exclusions, waiting periods, and filing deadlines that apply to your benefits application. Many of these requirements are stated in complex, difficult-to-understand technical terminology.

It’s very hard to file a successful claim unless you have a thorough understanding of your disability insurance plan’s rules and procedures. An experienced Edmonds disability lawyer, on the other hand, can assist you to identify:

  • The waiting, qualification, or elimination phases in the plan
  • How much time do you have to submit your claim?
  • Whether the concept of disability is based on “own occupation” or “all occupations.”
  • The policy’s exclusionary conditions and circumstances
  • The benefits to which you may be entitled
  • How long you’ll be able to receive benefits

Your disability insurance claim strategy will be built on this information.

Knowledge is a powerful tool.

A disability insurance lawyer at Cunnane Law can help you if you’re feeling overwhelmed by your ERISA claim or worried about insurance company monitoring. Cunnane Law approaches client interactions in a realistic, hands-on manner. We offer emotional support, case-specific information, and results-oriented techniques based on decades of disability law experience.

Respected disability lawyers offer practical advice

Cunnane Law’s disability lawyers have a solid reputation for aggressive advocacy and innovative methods. Moreover, we think that every disability claimant is entitled to client-centered representation and the best possible outcomes. We serve Edmonds, Seattle, Puget Sound, and all of western Washington State. Our clients can relax knowing that the lawyers at Cunnane Law are in charge of their disability claim. Contact us today.

Note: This information was provided not for any specific claim and is written in broad and general terms and may not be the right path to follow for a particular claim or case. This information is not intended to create an attorney client relationship. It is always best to receive direct legal counsel for your legal issues. It is never too early to call the attorney, but it can be too late.

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