Legal Question in Insurance Law in Colorado
Long Term Disability
I have a claim for long term disability with a company called CNA . They claim they have documentation from my medical records from my primary doctor diagnosing my fibromyalgia prior to 1-1-00.
They state I was diagnosed on 11/22/99. I have consulted my doctor and reviewed my medical records and there is no mention of a diagnosis of fibromyalgia until 6-1-00. I requested the alleged documentation from CNA and they refuse to send it to me. Is this legal? Is there any legal direction I can state or take?
Thank You.
1 Answer from Attorneys
Re: Long Term Disability
CNA must give you the details of the bases for the
claim denial. If this was told you on the phone,
don't get upset. You MUST write CNA and request
the material and a written response. Go from there.
Is this an ERISA claim? Is this insurance paid
for by your employer, or is it a personally bought
and paid for policy? There may be a big difference
in your legal remedies depending on the answer.
Also, make sure you have a copy of the actual policy,
and any brochures, applications, etc. If you don't
have this, demand copies in your letter to CNA.