You Counted on Their Promise to Pay. Make Them Keep It.
We Have Been Making Them Keep Their Promises for 30 YearsWhen you file your initial application for LTD insurance benefits, a lot is at stake. Our video explains why disability insurance companies deny so many legitimate claims.
But sometimes a claim is denied because of mistakes and omissions made on the application, by the applicant. Without skilled legal guidance, it is a rare case for a claimant to submit an irrefutable disability claim. One that would stand up in a court of law, if needed.
Like other recently disabled doctors and dentists, chances are you have considered suspending or deferring the specialty duties of your own occupation just so you can remain active in your practice. Be aware, the insurance company may use this against you.
The video above explains how insurance companies use every tactic they can to argue that claims for long term disability benefits are either undeserved or should be reduced. This occurs often with high-payout claims such as those for medical and dental professionals.
How do you file an LTD insurance appeal?
Our video illustrates just a few examples of denial tactics used by insurance companies to deny long term disability insurance claims. Is there a way you can fight back? Yes – you can challenge the insurer’s claim denial through the disability appeals process.
But there is a catch.
In the video above we discuss the insurance company’s tactic of “cherry picking” the records for evidence of your ability to work. This likely means the insurer is suppressing or ignoring evidence of disability as well.
You can call it many things – cherry picking, rejecting inconvenient evidence, selective observation, slanting, dismissing contrary evidence – but it all boils down to ignoring critical evidence. By doing so, an insurer is able to smother the relevant facts that prove you are unable to work.
Many disability claimants struggle with multiple impairments. And just as your LTD claim must link your health issues to your inability to work, it must also connect those various impairments to depict the totality of your disabling condition.
Listing multiple impairments can actually give insurers an opening to deny benefits. During their review of a long term disability claim, insurers often ignore, dismiss or intentionally isolate multiple medical conditions. They realize that, if all the health issues are considered as a whole, a reasonable review would find that claimant to be disabled.
As our video explains, an Independent Medical Exam for LTD benefits is anything but independent. In fact, it is a perfect example of an insurance company at odds with its own deserving customer. If your insurance company wants to schedule you for an Independent Medical Exam during their claim evaluation process, what can you do?
First of all, insurers are within their rights to request IMEs. This can apply whether you’re just applying for long term disability or you’re 5 years into a paying claim. In fact, many disability policies contain language that stipulates if you fail to cooperate or attend the IME, benefits may be denied or suspended.
You may have a disability insurance policy with Reassure America, now Jackson National Life Insurance Company. If you believe your benefits have been unfairly delayed or denied by this company, contact Marc Whitehead & Associates.
For over 24 years, we have held insurance companies, including Reassure America / Jackson, accountable for wrongfully denying the disability claims of insureds – physicians, dentists, nurses, attorneys, sales reps, teachers, laborers and so many other occupations.
If you have such a dispute, our disability insurance attorneys will evaluate your case, and help you resolve your conflict so you obtain the benefits you deserve.
Our video explains that in long term disability insurance claims, there is no single, comprehensive legal definition of disability. Each insurance company writes its own definitions. As a claimant, you will receive disability benefits only if you satisfy the precise description of disability as stated in your policy.
Why is it then that so many insureds are awarded short term disability (STD) benefits, only to have the benefits cut off, or denied for long term disability (LTD) benefits – under the same policy?
We are often contacted by individuals when they learn their insurance company has mischaracterized their claim from being a claim for a physical disability, to claim for a mental disability. Why would they do that?
As our video states, most disability insurance policies have a clause that limits mental health disorders, or “mental / nervous conditions,” to a pay period of only 2 years or less. Although most disabling mental disorders will outlive 24 months, the insurance carrier will not pay benefits beyond what the policy says.
Most long term disability insurance policies have limits in what they cover. These limits are written into the policy, and are called exclusions. Their purpose is to eliminate coverage for certain risks the insurance company is not willing to take on.
One very common example is the pre-existing condition exclusion.
