Disability Insurance Attorney: Tips for Dealing With the Insurance Company

Posted on October 31, 2018 by cjblog

If you’re filing a claim on a long-term disability policy that your employer has paid into or that you yourself have purchased, you are in for a bit of a fight. LTD insurance companies are notoriously stingy when paying out claims. They will repeatedly ask you for more information, deny your claim because there is insufficient evidence, or even accuse your doctors of being biased.

That is why many folks who file claims with their LTD policy carrier choose to have a skilled disability insurance attorney manage their claim. At CJ Henry Law Firm, we have built our reputation on helping disabled employees receive the funds they are entitled to.

It won’t be easy, but you can help the process along by following a few helpful tips.

1. Request a Copy of the LTD Policy

If you’re covered through your employer you should be able to request a copy from your human resources department. If you’ve purchased your own plan, you should be able to request a copy from the administrator or from your insurance company. There will be both a summary of the plan alongside the entire plan documents. There are a number of details that you should be aware of.

These include:

  • What triggers your plan? In other words, under what conditions will your plan pay out. There are typically two kinds of plans: Those that pay out when you can no longer work your current job and those that pay out when you can no longer work any job. These are known as “own occ” or “any occ” respectively. Typically, plans that begin as “own occ” will default to “any occ” after two years. “Any occ” plans usually pay out only if you cannot secure employment at 65% of your original earnings. You will need to consult your plan for details.
  • How many hours must you have worked for your current employer? Generally, plans purchased by your employer set a bar on how long you have worked for the company.
  • What are the policy exclusions? Policies may exclude certain conditions or self-inflicted injuries.
  • How long is the elimination period? The elimination period is like a deductible but instead of money, it costs time. There will be a time period between when your disability kicks and when your condition prevents you from working. During this period, you may be able to apply for short-term disability or use your vacation and sick days.

As when dealing with any important transaction, ensure that when you request the information you do so in writing and send the request through certified mail.

2. Be Careful How You Respond to Questions on Your Disability Application

Questions may be asked in a loaded fashion. In other words, they’re designed to elicit answers that give the insurance company cause to deny your claim. You want to respond to questions with facts concerning your case and you will need medical evidence to back up any claims you make.

3. Be Careful What You Say and Do

It’s important to bear in mind that insurance companies bear no resemblance at all to good neighbors and that you’re not in good hands. Insurance companies are for-profit businesses that make money by honoring as few claims as they can get away with. Nonetheless, they have a fiduciary responsibility to a policyholder and if they breach that duty, they can be sued.

But it’s important to understand that everything you say or do will be met with a great deal of scrutiny by the insurance company.

In addition, it is not uncommon for insurance companies to employ private investigators who will be searching through your social media and physically tailing you.

4. Beware of Insurance Company Doctors

The insurance company will likely request that you go see one of their doctors. This doctor’s job is to find evidence that you’re lying about your symptoms or exaggerating your symptoms. They have no other purpose. When you go to the doctor, simply explain what you can and cannot do. Don’t lie or exaggerate anything. They will be assuming you’re lying and/or exaggerating. Don’t give them ammunition to use against you.

Set a timer for when the examination begins and when it ends. Often, these examinations last for only 15 minutes. Nowhere near enough time to render an accurate assessment on anyone.

5. Hire a Long-Term Disability Insurance Attorney to Protect Your Claim

Sure, we’re a little biased, but the fact is applying for LTD benefits is not easy and it’s not simple. The cards are stacked against you and those you are asking to honor the claim are doing everything in their power to legally deny it. You should consult an attorney early in the process. It will help.

Contact CJ Henry Law Firm Today

CJ Henry Law Firm has helped numerous clients apply for long-term disability benefits. We have helped clients attain those benefits even after they had been denied. Contact us today to speak to a long-term disability insurance attorney.

This entry was posted in Blog by cjblog.