Welcome to our comprehensive guide on John Hancock disability claim denial. We are aware of the frustration and difficulties people go through when insurance companies reject their legitimate disability claims. This article aims to provide you with valuable insights and actionable steps to help you overcome the obstacles posed by a John Hancock disability claim denial.
Understanding John Hancock Disability Insurance
John Hancock is a renowned insurance company that offered various disability insurance products. Disability insurance is crucial as it provides financial protection to policyholders in case they become disabled and unable to work. Unfortunately, despite their marketing claims, insurance companies, including John Hancock, sometimes deny legitimate disability claims.
In 1992, John Hancock entered into a reinsurance agreement with a subsidiary of the Unum Group. John Hancock ceded the policy administration to the Unum Group. The Unum Group has a long history of parsimonious claim denials. Several years ago, a lawyer conducted a detail analysis regarding the Unum Group’s claim history. “Fifteen Years Later – Did the Unum Group Improve Its ERISA Claims Handling Practices? Claims Handling Practices?” By Philip W. Thomas published in the Mississippi College Law Review, Volume 39 Issue 2 (2021). The author concluded that the Unum Group had not improved its claim practices.
Reasons for John Hancock Disability Claims Denial
Insufficient Medical Evidence: One of the most common reasons for claim denials is the lack of substantial medical evidence to support the disability. It is vital to provide comprehensive medical records and expert opinions from treating physicians showing how symptoms of an illness or accident prevent the insured from performing occupational duties.
Policy Wording Misinterpretation: Insurance companies may exploit ambiguous policy language to deny claims. They might interpret certain terms in their favor, even if the policyholder’s situation aligns with the intention of coverage. This is even against a universal legal principle which holds ambiguities in insurance policies must be construed against the insurance company and in favor of the policyholder.
Excluded Conditions: Some policies have exclusions for disabilities caused by certain acts. If the insurance company deems the disability related to an excluded cause, the company may deny the claim. Typical are:
- Acts of War: If you are injured or become ill during your time in the war, the issues may be excluded from your disability coverage.
- Suicide attempts. Often suicide attempts that lead to disability will be excluded.
- Flights/Aircraft: Injuries occurring due to private aircraft travel may be excluded. This will not apply for regularly scheduled commercial flights.
- Civil Disturbance: If you’re involved in any type of civil disobedience or disturbance, it may not be covered under a disability policy.
- Commission of felony: If you are injured as a result of taking part in felonious conduct, the claim may be excluded.
- When your policy is specifically underwritten, and a medical exam discovers a pre-existing medical condition, sometimes claims arising from that medical condition are excluded.
Your Rights as a Policyholder
As a policyholder, you have certain rights that protect you during the claims process:
- Right to Appeal: If your claim is denied, you have the right to appeal the decision. The appeal process allows you to submit additional evidence and arguments to support your claim.
- Right to Review: You can request a detailed explanation for the denial. This will help you understand the specific reasons behind the decision.
- Right to Legal Representation: You have the right to seek legal counsel to guide you through the appeals process. An experienced disability insurance attorney can be instrumental in building a strong case.
Overcoming a John Hancock Disability Claims Denial
If your John Hancock disability claim is denied, don’t lose hope. You can take the following steps to increase your chances of a successful appeal:
- Gather Comprehensive Medical Records: Obtain detailed medical records from all treating physicians, including specialists and therapists. These records should highlight the severity and impact of your disability and how the symptoms prevent you from working.
- Obtain Expert Opinions: Seek opinions from medical experts who specialize in your condition. Their professional insights can carry significant weight in the appeals process.
- Review Policy Wording: Thoroughly examine your insurance policy to understand the terms, conditions, and exclusions. This will help you identify any misinterpretations by the insurance company.
- Craft a Strong Appeal Letter: Prepare a compelling appeal letter that addresses the reasons for the denial and presents strong arguments supported by evidence.
- Consult with an Attorney: Consider seeking legal representation from a qualified disability insurance attorney. They can guide you through the process and protect your rights.
Facing a John Hancock disability claim denial can be overwhelming but remember that you have rights and options to contest the decision. By gathering robust evidence, reviewing policy wording, and seeking professional help, you can improve your chances of a successful appeal. Jonathan Feigenbaum is committed to assisting you throughout this process and ensuring you receive the disability benefits you deserve. Remember, persistence and preparation are key to overcoming these challenges and securing your financial future.