It’s important to learn about long-term disability benefits termination red flags. Insurance companies are more than happy to terminate your disability claims. It boosts their bottom line. Insurers carefully analyze claims, looking for anything disqualifying. Some of these actions are legitimate, as disability fraud does occur. However, in most cases, patients need their benefits because they are genuinely disabled.
A wrongful termination lawyer at Marc Whitehead & Associates can help you fight a long-term disability benefits termination. We are well-versed in insurance industry tactics and know the red flags insurers use to avoid paying benefits.
Top Red Flags
The list of insurance industry red flags for denying benefits is lengthy. While much depends on your unique circumstances, here are some of the most common reasons given for the denial or termination of benefits:
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Incomplete medical reports
Insurance companies often state they did not receive necessary medical reports. That translates into claim denial. Make sure medical reports are submitted in a timely manner and include records from all healthcare providers.
Incorrect medical reports
Healthcare providers make mistakes, and inaccuracies in your medical reports can result in termination. This may include misspelled or incorrect medical terminology. The insurance company will use these errors to attempt to prove your medical providers are unqualified.
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Lack of medical evidence
It is wise for you and your doctor to provide as much evidence as possible regarding your disability. Always err on submitting too much evidence rather than too little, even if it seems excessive. Insurance companies often allege a lack of medical evidence in denying claims.
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Frequently changing physicians
There are plenty of legitimate reasons to change physicians. However, insurance companies are looking for patients who may “doctor shop,” e.g., looking for a healthcare provider who might be more likely to modify a report.
Malingering
If your disability appears more severe or lasts longer than average, the insurance company may accuse you of malingering or exaggerating your condition to continue receiving benefits. Some insurers may contact your healthcare providers to persuade them to change your status so you can return to work.
Non-compliance with your treatment plan
Complying with the treatment plan is vital. Failure to do so will often result in the termination of disability benefits. For example, keep your appointments if the treatment plan stipulates regular physical therapy sessions.
Performing activities inconsistent with your diagnosis
Be careful when you post on social media as the insurance company may be watching your account. If it looks like you are participating in any activities that you reported you could not do, termination of benefits may soon follow.
In addition, using surveillance video outside your home is a common practice. For example, lifting grocery bags out of your car and bringing them into the house may disqualify you from receiving benefits–if you reported that lifting and carrying was beyond your capability.
Contact a Disability Insurance Claim Lawyer
If your long-term disability benefits were terminated, you need the services of an experienced disability insurance claim attorney at Marc Whitehead & Associates. Since our founding in 1992, we have helped disabled individuals fight for and win their rightful long-term disability insurance benefits. Our law firm has developed a proven approach that, in turn, gives our clients the best chance of being approved for benefits.
We have offices in Texas, but we serve clients nationwide. Schedule a free, no-obligation consultation today. We work on a contingency basis, so there are no upfront legal fees.
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