Filing A Disability Insurance Claim? Here Are The Dos And Dont’s
The process of filing a long-term disability insurance claim can be tricky. While every claim provides its own unique challenges, many of these issues arise when claimants make seemingly small mistakes during the claim filing process.
Here is a list of dos and don’ts that may help you bulletproof your long-term disability insurance claim.
When filing a disability insurance claim, do:
Respond quickly to all requests for more medical, vocational or financial information from your insurance company
Failure to provide documents in a timely manner causes unnecessary delays and can drag the claim process out. Long-term disability claims often take a substantial amount of time to resolve; providing your information in a timely manner eliminates extra delays in an already lengthy process.
Respond in writing to questions from your insurance company
Insurers may try to communicate over the phone. When possible, it is best to respond to all claim-related questions in writing. Verbal answers are easier to misinterpret than written answers, and your own words may be used against you in your claim for benefits.
Make and keep copies of all correspondence with your insurance company, including anything you have sent them or received from them. Take detailed notes of every phone call with your insurance company and pay attention to the time, date, who you spoke with, and what the call was regarding.
Remember that nothing you say to the insurer is “off the record”
Everything you say or send to the insurance company can be used to delay or deny your claim. Choose your words carefully and make sure you are not sending unnecessary personal information. Learn more about which documents your insurance company is entitled to.
Fill out all claim forms accurately, truthfully, and factually
Insurance claim forms are notoriously complicated and misleading. It is important to answer each question fully to avoid fatal mistakes that can lead to a denial of benefits.
Insurance companies have a field day when they find omitted or partially submitted misinformation on your forms. Insurers often cite that misinformation and try to call it fraud. The insurance company can claim you concealed, misrepresented and committed fraud by failing to disclose fully what they deem “pertinent medical or financial information”.
If you have questions, or concerns or are uncertain about what the forms are asking, contact a top-rated disability lawyer for a free consultation.
Communicate regularly with your treating physician
Meet with your doctor to gather information relevant to your claim, such as:
- An outline of your diagnosis and why you are disabled
- The dates you became unable to work
- List of restrictions and limitations, both physical and cognitive, that prevent you from working
Get timely, objective tests and regular treatments when necessary, and have everything documented. If there are gaps in treatment, document them and explain why. The more complete your medical records are, the more information you have to support your claim for benefits.
When filing a disability insurance claim, do not:
Discuss your claim on social media
Social media may only show a small portion of your life, but insurers can take your willingly shared information at face value and use it against you.
Insurance companies build a “history of behavior” from your social media activity that supports their assertions about your disability and can invalidate your claim.
Reduce or cease social media activity on Facebook, Twitter, LinkedIn, Instagram, Tumblr, Snapchat, or any other sites you use once you file a claim. Even seemingly innocuous content can be interpreted in a way that contradicts your assertion of disability. Learn more about how social media activity can endanger your insurance claim.
Perform activities inconsistent with your restrictions and limitations
Once you file a claim, your insurance company will run surveillance on you and attempt to prove you are not really disabled. While this may not seem legal, insurance companies are entitled to evaluate what you said on your claim forms with how you appear in public.
If your disability prevents you from performing certain activities – such as lifting 10 pounds – make sure you follow the restrictions and limitations set forth by your doctor. If your insurance company videotapes you performing those activities in public, that footage will be used against you.
Use the words “never” or “always” in your claim forms
Stay away from those two little words when completing your claim forms. If your insurance company finds evidence that you performed a certain activity you stated you can “never” do, or that you did not take medication you said you “always” need, expect a denial of benefits.
Agree to exams or evaluations without first understanding the terms of your policy
Your insurance company will likely ask you to participate in a field visit, independent medical exam, and/or functional capacity evaluation. Before you say yes, examine your policy closely. Are you required to comply? If so, consult an experienced disability insurance attorney before the field visit, IME or FCE to ensure you know your rights.
Miss any internal policy deadlines
Deadlines are a frustratingly difficult aspect of the insurance claims process. Many disability insurance policies have strict time limits for filing or giving notice of a claim. Failure to meet these proof of loss deadlines often ensures a denial of benefits.
Pay close attention to these time limits, as well as any bad faith tactics that might contribute to missed deadlines or rushed, poorly completed forms submitted to meet short deadlines.
Take no for an answer
Insurance companies are in the business of denying claims; if your claim is denied, do not give up. Instead, learn what your next steps are; the type of policy you have will indicate what options are available. You may be able to file an appeal or sue your insurance company if they acted in bad faith.
If you have specific questions about your disability insurance claim, or if your claim was denied, contact an experienced long term disability attorney for a free consultation.