Whether you received long-term disability coverage as part of your employment benefits or purchased your own policy, you have the right to expect your policy to be honored if a disability keeps you from working. Unfortunately, the approval rates for disability claims are falling every year. If you are one of the growing percentage of Americans who weren’t approved, it isn’t the end of the road. LTD benefits denied or terminated by the insurance company are subject to appeal or legal action.
CAN YOU WORK WITH THE INSURANCE COMPANY?
Even though buying insurance can feel like any other consumer transaction, having LTD benefits terminated or denied isn’t something you should treat as a customer service issue that can be resolved by talking to a manager. Insurance companies are in business to make money, and the way they do this is by minimizing their payments on claims.
Even if the insurance company expresses a willingness to work with you, you should exercise extreme caution. Watch out for the following traps in both your initial policy and in new documents they may ask you to sign.
- Arbitration clauses that bar you from filing a lawsuit if you are unhappy with the outcome
- A provision that you automatically accept the insurance company’s findings if you don’t respond within a certain amount of time
- An offer to partially settle your claim that waives your right to pursue further action
- A lengthy claims or appeals process that extends beyond the deadline to file a lawsuit
To avoid giving up important rights, talk to an LTD benefits lawyer before you take any action with the insurance company.
HOW CAN YOU FIND OUT WHAT YOU’RE ENTITLED TO?
Each long-term disability insurance policy offers varying levels of coverage but should generally include time-loss, medical care, prescriptions, and related expenses. Coverage may depend on whether the injury occurred on or off the job, whether you were partially at-fault, what type of injury you suffered, and what treatment you need. Even covered items may have different coverage limits depending on the circumstances.
Your insurance company wrote the fine print, and may try to interpret it to their advantage. Unless you want to trust them on their word or are satisfied with your own ability to read and argue the nuances of a complex contract, bring your insurance documents to our office so an experienced LTD attorney can review them. We may be able to identify a provision that requires the insurance company to honor a claim they initially denied or terminated.
WHEN SHOULD YOU TALK TO A LONG-TERM DISABILITY ATTORNEY?
The right time to talk to a long-term disability attorney is as soon as possible. If you fail to follow the legal procedures needed to bring your claim to the letter and in a timely manner, you may forfeit the right to appeal a denial of your benefits or to have your benefits reinstated after termination.
Working with an attorney who regularly handles disability claims from the beginning can potentially help the application process go smoother and get your claim paid faster. Having an attorney who knows what proof the insurance company is looking for can also help reduce the chances your claim will be denied for lack of documentation.
Even if your claim has already been approved, there may still be times when you want to talk to an LTD attorney. One is when you want to make sure the insurance company gave you everything you were entitled to. Another is when you want to return to work in a different capacity or start a physically-active hobby and you fear the insurance company may try to terminate your disability benefits.
To schedule a free evaluation to discuss your specific situation, contact the attorneys at Levine Benjamin today.
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