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“Discretionary Language” is used by insurance companies to deny or terminate ERISA disability claims

What does it mean when an insurance company has written in “discretionary language” to a ERISA disability policy? Simply put, it means the insurance company gets to determine who is eligible for benefits and who is not. The discretionary language clause is often at the end of the insurance company’s disability policy or the summary of benefits you receive from your employer – it looks like another line of legal mumbo jumbo but in reality is the reason many people’s disability claims are denied.

If you get your disability benefits through your employer as most Americans do, your claim will almost certainly be subject to discretionary review. Armed with “discretion” to review your ERISA disability claim, the insurance company who already has a major conflict of interest in that it decides whether you are disabled and also has to pay the claim, is then able to retain its own doctors, aka “hired guns,” to review your claim who usually disagree with you and your doctors that you are disabled.

The insurance company then denies your claim using the “discretion” afforded to it in the ERISA policy after accepting its own doctors’ opinions and rejecting your statements and doctors’ opinions that you are disabled.

Many people are shocked to learn a disability insurance company can reject their treating doctor’s opinion – but these conflicted companies do it every day by hiding behind discretionary language they write in their disability policies.

Never trust that the insurance company has your best interests in mind – they are too conflicted to do so.

ERISA is a very complex area of the law so it is best to consult with an attorney who concentrates their practice on these types of cases. We recover millions of dollars in disability benefits for our clients every year and we represent more ERISA disability claimants in Arizona than any other law firm, call us for a free consultation regardless of where you are in the claim process (602) 482-4300 or in Las Vegas (702) 732-4410.