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My Insurance Company Won’t Talk To Me – What Do I Do?

Hire an attorney. Although a long-term disability claimant – the insured – carries the burden of showing she is entitled to benefits, 6 ERISA administrators (usually, but not always, insurance companies) have a fiduciary duty to conduct an adequate investigation when considering a claim for benefits. Cady v. Hartford Life & Accidental Ins. Co., 930 F. Supp. 2d 1216, 1226 (D. Idaho 2013)(citing Booton v. Lockheed Med. Ben. Plan, 110 F.3d 1461, 1463 (9th Cir. 1997)). See also, Rasenack v. AIG Life Ins. Co., 585 F.3d 1311, 1324 (10th Cir. 2009). “This requires that the plan administrator engage in ‘meaningful dialogue' with the beneficiary. If the administrator ‘believes more information is needed to make a reasoned decision, they must ask for it.'” Cady, 930 F. Supp. 2d at 1226 (quoting Booton, 110 F.3d at 1463). A plan administrator may not “shut [its] eyes to readily available information when the evidence in the record suggests that the information might confirm the beneficiary's theory of entitlement." Rodgers v. Metropolitan Life Ins. Co., 655 F. Supp. 2d 1081, 1087 (N.D. Cal. 2009) (citations omitted).

However, all too frequently that is what happens – an insurance company fails to engage in any meaningful dialogue with its insured and, accordingly, fails to conduct an adequate investigation such that its behavior is arbitrary and capricious under the law. If you hire an attorney he or she can force the insurance company to pay attention to your claim.


Seth has always been compelled to excel, whether it meant earning his Eagle Scout as a teenager, participating in theater, debate and varsity football in high school, his Rhodes Scholar candidacy in college, or opening his own law firm. He also perseveres in situations others might shy away from, whether it involves sky-diving, rappelling down a mountain, white-water rafting, participating in marathons and triathlons, writing a novel, or lecturing nationally to large audiences about the vagaries of ERISA.


Seth is committed to serving disabled individuals. He is proud of his work in prominent organizations such as the American Association for Justice (AAJ), the Tennessee Bar Association (TBA) and Hospice. Seth is past-Chair of both AAJ's & TBA's Disability Law Sections, past-President of the Chattanooga Trial Lawyers Association, a 2-time recipient of the Pro Bono Excellence Award, and a 7 year member of the Board of Directors for Hospice of Chattanooga.