What does insurance buy? For many, the answer is peace of mind, because the reality is, we all hope we never have to use it. Whether required by law, such as auto insurance, or optional, like long-term disability insurance, if you’re filing a claim, it means something has gone wrong that has cost you money. As bad as that can be, imagine finding out the coverage you thought you had is being denied by your insurance carrier. Unfortunately, this occurs all too frequently with many Disability insurance companies. Learn what you can do to protect yourself.
Read Your Policy
This may sound basic, but too often people don’t read their policy. Although the language can be mundane and perhaps confusing as well, it is not a good idea to rely on someone else (especially the insurance company) to tell you what your policy covers and, more importantly, what it does not.
Understand Your Policy
The primary issue to understand is what determines eligibility. You may think you know, but pay specific attention to the policy’s language. Despite the use of a plain-English word, there may be a section in the policy that “defines” that word differently for purposes of the policy. Basic terms, such as “disability,” are defined in the policy and how those terms are interpreted will be critical to the outcome of your claim.
Be Aware of Insurer Tactics
An insurance company may employ many different tactics in an effort to deny your claim, including, for example:
- Being vague or downright deceptive in explaining coverage when you first obtain the policy;
- Blaming you for failing to provide the necessary documents to properly process your claim;
- Claiming not to have received documents you sent;
- Sending you the wrong claim forms;
- Basing your denial on standards not contained in your policy; and/or
- Employing biased medical personnel to review your file and incentivizing them to encourage denials.
If you have received a denial letter, do not automatically assume that is the last word on your claim. You have the right to an appeal. It is critical, however, that you file a timely appeal and that your appeal includes all the information that may be advantageous and relevant to your claim. If you don’t, and your appeal is denied, you may not be able to introduce that favorable evidence in subsequent litigation.
Contact a Disability insurance Lawyer
Insurance is a big business that seeks to generate profits – sometimes through the denial of legitimate claims. A Disability insurance attorney can help you level the playing field. Call us today to schedule your complimentary initial consultation.