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Northwestern Mutual Disability Claims Lawyer

CaveyLaw.com > Disability Insurance Companies > Northwestern Mutual Disability Claims Lawyer

You bought your Northwestern Mutual disability insurance policy with the promise that Northwestern Mutual would be there for you and your family in case you become disabled and unable to work.  You thought you were buying financial peace of mind, but unfortunately, that is rarely the case.

Northwestern Mutual’s History

 

Northwestern Mutual is a financial security company that provides wealth and asset protection, retirement planning, investment planning, trust, and private client services and insurance products, including life and disability insurance.

 

In 1969 it began to offer disability insurance and it is one of the largest private disability insurance companies in the United States. It offers customizable individual disability or ID policy to doctors, dentists, and other professionals to protect not only their income but their lifestyle. Did you know they are the sponsor of the Rose Bowl played on New Year’s Day? It is the “Granddaddy of Them All”?

 

I am insured by Northwestern Mutual!

 

Some of the many disputes that arise are the date of disability, claims for residual disability when the professional continues to work, the occupation the policyholder is performing when they became disabled, total disability and the coordination of the Northwestern Mutual policy with other ID policies or ERISA group disability policies the policyholder may own. That coordination is a key issue since many of my Northwestern Mutual clients have more than one disability policies with different carriers. It is like untangling Christmas tree lights before you plug them in.

 

The Disability Insurance Claim Survival Guide for Professionals is a book that I have written for professionals. Before you stop working and apply for benefits, you owe it to yourself and your family to get a copy.  Doing so can help you know if you have adequately protected your career. You may work regularly with insurance companies, but that does not make you an expert on disability insurance. In fact, fewer than 200 lawyers in the United States are what I would call an expert and I am one of them.

 

How Northwestern Mutual Makes Money with Your Insurance Premiums

 

Northwestern Mutual has continued its strong growth as a commercial state investor and lender by participating in major transactions on both east and west coast. In fact, Northwestern Mutual recently sold the Seattle Towers for a substantial amount of money. By purchasing Class A properties and projects, Northwestern Mutual has increased its portfolio to over $30.2 billion.

 

Long term disability carriers like Northwestern Mutual use your premium dollars to invest in real estate transactions- and you thought they were just using your premium to pay disability benefits.

Northwestern Mutual is tough but fair. It will:

 

  • Utilize in-network medical staff to review medical records and reach conclusions about the policy-holders restrictions and limitations even though those individuals may have no training in or qualifications to render any opinions about the policyholder’s medical conditions,
  • Utilize biased medical peer review providers to create medical justifications for a claim’s denial so Northwestern Mutual can claim that you are perfectly capable of performing the material and substantial duties of your occupation,
  • Utilize in-network financial professionals to determine your earnings pre-disability and calculate your residual benefits, based on their analysis of your books, billings, and schedule,
  • Utilize surveillance companies to discredit the policyholder’s complaints,
  • Utilize any excuse to schedule a personal visit to your home to show you “Dancing with the Stars” video they have and give you the “we got you now” award that will result in the termination of a claim.
  • Utilize in-network vocational evaluators to misclassify your occupation and your ability to perform your occupation, perform questionable transferrable skills analysis and misinterpret the wages of and availability of other occupations it will claim the policyholder can do to justify the denial or termination of benefits.

 

Your claim is a very expensive claim and will cost them a lot of money.  Although they are generally fair, if they denied a claim they will fight. Northwestern Mutual has nothing to lose! You need an experienced lawyer, like myself, who battles Northwestern Mutual.

 

A Northwestern Mutual Disability Claims Attorney will help you by:

 

  • Thoroughly reviewing your policies,
  • Thoroughly reviewing your medical records,
  • Creating a pre-claim strategy to get your benefits approved on the initial application,
  • Appealing a wrongful denial or termination and writing an appeal letter (25 to 60 pages long) that is the trial of your case and goes to Northwestern Mutual,
  • Protecting you from aggressive claims handling, including any delay games, more information needed games, we need a statement games or we need to have you under an independent medical examination or FCE,
  • Aggressively litigating your case, if need be.

 

Don’t let Northwestern Mutual delay, deny or terminate your benefits.

 

Make no mistake about it, Northwestern Mutual plays games with initial applications and makes endless and multiple requests for medical, financial, and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains your bank accounts as you try to stay financially afloat.

 

Northwestern Mutual uses “liar for hire” medical professionals who give Northwestern Mutual the ammunition it needs to justify a claim’s denial or termination. Northwestern Mutual rarely tells a denied policyholder, like you, the real reasons the claim was denied. Worse yet, Northwestern Mutual fails to fully explain what you need to submit to successfully win an appeal. That’s why it is crucial that you be represented at both the initial application and appeal stages of a Northwestern Mutual claim by an experienced disability claims lawyer, who battles Northwestern Mutual daily.

In The Northwestern Mutual Appeals Process, “DIY” Is Not Advisable

 

Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Northwestern Mutual), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by the Employee Retirement Security Act or ERISA.

 

Despite its name, the ERISA statute and regulations are NOT policyholder friendly.  You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Northwestern Mutual’s file which is stuffed with medical and vocational opinions that are favorable to Northwestern Mutual. If you didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational, or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.

 

An appeal of a denied Northwestern Mutual claim is the trial of your case. Taking on a tough insurance company like Northwestern Mutual is an endeavor for a specialist. A federal judge will give Northwestern Mutual the benefit of the doubt because your Northwestern Mutual policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on Northwestern Mutual. After all, this is about getting the disability benefits you deserve and you paid for.

 

Some policyholders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Northwestern Mutual. Don’t think that Northwestern Mutual isn’t playing the claims delay, denial, or termination game with individual disability policies. They are, and the policy benefits at stake are high. There is much more to lose if you aren’t represented by a Northwestern Mutual individual disability attorney like me.

 

Three Types of Disability Policies that Northwestern Mutual Offers:

 

Group ERISA Disability Insurance

 

Northwestern Mutual offers disability policies through employers which are governed by ERISA. A Northwestern Mutual ERISA policy generally has the following:

  • strict definitions of disability and occupation,
  • limitations on how long payment will be made for mental conditions or subjective conditions like  headaches, pain, fibromyalgia or chronic fatigue,
  • “other income” provisions that allow for a dollar for dollar reduction for the receipt of Social Security disability benefits, workers’ compensation benefits, and personal injury settlements, and
  • A “golden handcuff” on a judge that only allows for a claims denial or termination reversal if Northwestern Mutual’s decision is “arbitrary and capricious.”

 

Group Non-ERISA Disability Insurance

 

However, a group plan offered by a church plan, such as the Catholic Church, or by a municipal employer like the City of Baltimore, Baltimore County, or the State of Maryland is NOT generally covered by ERISA. The policy terms are much like those of an ERISA plan but there is one CRUCIAL difference. A claim denial or termination can be challenged in state court and new evidence can be submitted at trial.

 

State law courts are a much friendlier place for a policyholder than Federal court. You are entitled to a jury trial in a state law claim and not some Federal judge just making a decision based on Northwestern Mutual’s file stuffed full of things that are unfavorable for you!

 

Individual Disability (ID) Insurance

 

Without a doubt, the best and most expensive policy is a private individual disability policy known as an ID policy. The policy terms and coverage are broader and more generous. But that means a high monthly premium and a lot of financial exposure that Northwestern Mutual has if you become disabled. It isn’t uncommon for Northwestern Mutual to invoke a pre-existing exclusion or a medical condition policy rider right out of the box as a way to justify a denial of the claim from the beginning of the claim. That is just one reason why it is so important for a policyholder to contact me BEFORE they stop working and apply for benefits.

 

For example, let’s say you are a dentist who has a policy that excludes any claims for disability as a result of carpal tunnel syndrome but you now are unable to work because of a herniated cervical disc. The symptoms of carpal tunnel syndrome can mimic those of a herniated cervical disc that causes tingling, numbness, and weakness of the hand.

 

You can bet that Northwestern Mutual will be looking for a way to say that you are disabled as a result of carpal tunnel syndrome and not a herniated cervical disc. Do you know what your medical records say about your medical history, your carpal tunnel complaints, how your complaints are different because of the herniated cervical disc, or how they impact on your practice is different than your carpal tunnel symptoms? Northwestern Mutual fights an individual disability claim as hard, if not harder than an ERISA claim and costly mistakes can be made at the initial application and appeal stages of a case.

 

Hire A Lawyer Experienced in Northwestern Mutual Disability Claims

 

The disability claims process can be difficult to navigate on your own without legal assistance. Attorney Nancy Cavey has the experience and knowledge of how insurance companies like Northwestern Mutual operate, and how you can successfully appeal your denied claim. If you have further questions, or to get the help you deserve, contact The Law Office of Nancy L. Cavey today.