Even if your disability insurance policy seems iron-clad, there is a good possibility that your claim will be heavily scrutinized and even denied. In fact, with some companies, an initial denial is not uncommon.
If your claim was denied, here are some common possible reasons.
1. Missed Deadlines
Every legal process is detail-driven, but none more so than long-term disability. If you miss a deadline, an insurance company will use that to disqualify your claim.
2. Inadequate Paperwork or Evidence
You need to prove you were injured, which means any records that could substantiate your version of events needs to be filed with the insurance company. Without adequate evidence, the insurance company will have no choice but to deny you.
3. Definition Issues
Your injury may not meet the threshold for “disability” in the eyes of the insurance company. In this case, a long-term disability claim lawyer may be able to help you get the compensation you deserve.
4. Employer Contract Reasons
Even if your LTD policy seems sound, it may have stipulations that allow an insurance company to deny a claim. This can include pre-existing conditions, excluded activities, etc.
5. Non-Compliance with the Insurance Company
If an insurance company can argue that you refused to undergo treatment, go to rehabilitation, attend an independent medical assessment, or return to work, it will. Follow every piece of medical advice you get and do whatever the insurance company requests.
6. Your Own Behavior
Insurance companies can and will investigate your claim and surveil you and your social media to try and establish a lack of credibility. If you have a back injury, for example, do not participate in activities that could throw your claim into question.
7. Failure to Communicate with the Insurer
Filing your claim is the beginning of your relationship with the insurance company. Check in regularly, provide them with the information they request, and maintain an active and regular communication channel with them.
8. The Insurer is Not Your Friend
Insurance companies will claim to be your ally in disability insurance cases. Do not be deceived. Their purpose is to protect their clients and avoid any payout they can. Always keep that in mind when you are communicating with them.
If you are injured, the best step you can take is to get professional legal help. Contact the attorneys at Rosen Moss Snyder LLP, the top ERISA disability lawyers in Philadelphia, as soon as you think you have a claim and get a free consultation regarding your case and next steps.