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.
How A Disability Attorney Can Help You Win Your Long-Term Disability Claim
Having the help of an experienced lawyer will often make the difference between being successful with your claim or dealing with either a denial or lower benefits than you deserve. Insurance companies are known for taking advantage of all kinds of tricks and strategies to pay less than they should, simply because it helps their profits.
A long-term disability attorney can help you protect your interests and present your case by:
- Analyzing Your Policy In Detail: Long-term disability policies are incredibly complicated, with several layers of requirements to wade through. Your attorney can evaluate your specific policy and help you develop an effective strategy for filing a claim.
- Preparing Your Paperwork: It’s very common for insurance companies to deny an initial application over technical problems like forms that weren’t completed correctly or missed deadlines. Your attorney helps you overcome these kinds of hurdles while also making sure that all the proper evidence has been gathered and submitted.
- Preparing an Appeal, if Necessary: It’s also common for legitimate disability claims to get an initial denial, simply as a strategy to make the process harder and pay out fewer claims. Disabled individuals that get a denial letter will often have only 180 days to gather more evidence of their disability and appeal the insurance company’s decision. Having a disability lawyer will significantly boost your chances of success, especially if the reason for denial was something serious. An experienced attorney can recommend additional medical tests, arrange for the testimony of a vocational expert, and put you in a stronger position overall.
- Managing the Process for You: The most significant advantage of having a disability attorney handle your claim is that you probably already have quite a lot on your plate while dealing with your health issues. Your lawyer can ease this burden by communicating with your insurance company, obtaining additional evidence, preparing all the paperwork, and generally providing support during every step.
Why You Should Contact The Experienced Team At DarrasLaw
Whether you’re just beginning your long-term disability claim or are preparing to appeal a denial, the skilled attorneys at DarrasLaw can help you build a stronger case. We’re very familiar with the tactics of unethical insurers that make this process as complicated as possible, putting disabled individuals in a very vulnerable position. DarrasLaw is proud to be a valuable resource every step of the way, which means you don’t have to face the insurance company alone.
As a longstanding disability insurance firm, our team has received over $1 billion in disability benefits wrongfully denied to our clients. Reach out today by calling (800) 458-4577 or use our online contact form to share more information about your claim. You can talk to our case managers and receive a case evaluation for free. There is no risk to you–our attorneys only get paid if they get you approved for benefits.
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.