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Tactics Long-Term Disability Insurance Firms Use to Deny Your Benefits

When you first contact an insurance company to purchase a long-term disability insurance policy, you might buy into the company’s attempts to portray itself as a caring, client-focused business. When it comes to claim time, this impression often swiftly evaporates.

The reality is that disability insurance providers devote a lot of resources to finding ways to delay the payment of benefits or deny claims outright. It’s part of the reason why today they’re able to turn massive profits year after year.

Therefore, it’s important to arm yourself with knowledge about their favorite denial tactics before you file a claim.

Using Delay Tactics

Rather than issuing a claim denial right away, insurance companies often prolong the process using various strategies. They might continually request new medical, financial or occupational evidence or require you to return different forms, or repeatedly put new adjusters on your case. The company will justify these practices to you in different ways, but the truth is that they are designed to increase the length of time it takes to honor your claim.

This reduces the amount of time they’ll ultimately end up paying monthly benefits, as you’ll no longer be entitled to benefits once you’re fully recovered. Additionally, some claimants get so frustrated with the contrived process that they simply give up on it completely.

Searching for Admission

You should always exercise caution when filling out forms related to your long-term disability insurance claim or speaking to one of your insurer’s representatives over the phone. Seemingly innocent or unimportant questions can be designed to trick you into revealing a piece of information that could completely invalidate your claim or faking to timely provide a proof of loss.
Additionally, insurers often ask for important information in a deliberately vague way. When you respond with a broad answer, the company will later present the information you gave them in the way that best supports the case they’re trying to make, damaging or eliminating your claim.

For this reason, you should always aim to be as detailed and specific as possible when answering questions about your symptoms and the extent of your disability. Your lawyer can help you to do this in a way that supports your claim, rather than damaging it.

Checking Social Media

Claimants’ social media profiles are a treasure trove for disability insurance providers. They’ll look at all the publicly available content you’re tagged in or have posted yourself, especially photos and videos, for any evidence that might hurt your case. If, for example, you say you are unable to carry out full- or part-time work because of a leg injury, your insurer’s attorneys will look for any photos or videos of you running, cycling, going to the gym, or partaking in another form of strenuous exercise to support their contention that your injury is less serious than you say.

Make sure to update the privacy settings on all your social media profiles so that only people you know can view your activity. Also, don’t accept any friend requests or follow requests from profiles you’re not familiar with. Last, take down your LinkedIn as the carrier will say you are telling the world you are still available and ready to work.

Contacting Your Physician

Insurance companies may contact your healthcare provider directly for information about your disabling symptoms and treatment. Unfortunately, there are several ways insurance companies can hurt your claim through these interactions.

Doctors often receive unscheduled calls from disability insurers, which means they won’t have your medical records at hand and may be preoccupied with other matters. In this situation, your physician may attempt to answer questions about your disability off the top of their head, making it more likely they’ll give vague or inaccurate responses. Remember, insurance claims people know exactly how to ask questions that will produce the answers to hurt your claim.

To make sure your doctor doesn’t inadvertently work against you, it’s a good idea to ask your doctor that any contact they have with your insurer be in writing.

Conducting Surveillance

Long-term disability insurance companies also hire investigators to track and record claimants’ movements. They’ll attempt to collect video evidence of you engaged in an activity that will prove you’re not disabled and deny your claim.

These investigators are consummate professionals, so there’s only so much you can do to keep yourself out of their line of sight. However, the evidence they gather is often insufficient to defeat claims by itself. Remember, being disabled for the purposes of long-term disability insurance means you’re unable to execute your professional duties, not that you’re incapable of doing anything at all. Our Massachusetts ERISA attorneys are experts when it comes to defeating strategies like this in the courtroom and at the negotiation table.

Requesting Independent Medical Examinations (IMEs)

Your long-term disability insurance policy may demand that you undergo an independent medical examination (IME). In reality, these examinations are rarely independent. The physician assessing you gets paid by your insurance provider, meaning they have an incentive to draw conclusions that will diminish your claim and lend to a denial.

The best way to protect yourself from this tactic is to comply with the directions you get from your healthcare provider to the best of your ability. Undergo the treatments they suggest and provide them with accurate information about your disabling symptoms at every opportunity.

If you can help document that your condition is truly disabling and that you’ve done everything possible to improve it, any conflicting evidence from an IME will count less.

Protecting Yourself From the Tricks of the Long-Term Disability Insurance Trade

By now, you should have a much greater understanding of the lengths to which your disability insurance provider will go to avoid paying out on your long-term disability claim. Without a top-class long-term disability insurance attorney on your side, your entire claim could be in jeopardy, even if it’s completely genuine.

Don’t leave it to chance. Request a free consultation in relation to your policy, claim, or appeal. Remember, there are strict, tricky deadlines when it comes to the administrative appeals process in employer-sponsored group disability insurance policies. You need to return a fully comprehensive appeal in a timely fashion if you want your ERISA disability claim to succeed, so don’t delay.

DarrasLaw is Americas' most honored and decorated disability litigation firm in the country. Mr. Darras has seen more, evaluated more, litigated more, and resolved more individual and group long term disability and long-term care cases than any other lawyer in the United States.

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