Disability Insurance Denials: All Too Often

Sadaka Associates Consumer Fraud, Disability Insurance Denials

The last thing you want to hear when you are disabled is that you don’t qualify for assistance. Yet, long term disability insurers deny thousands of claims every year. While long term disability attorneys admit that some denials are certainly valid, they say that many more are not, for no apparent reason at all. So, the question is, why are so many long term disability claims denied?

Long term disability claims are claims against an insurance company for failing to pay long term disability benefits. They protect individuals who suffer a disability from enduring large financial losses because they have lost their ability to perform their job duties. Common reasons for long term disability claims include cancer treatment, heart disease, pregnancy complications, back injuries and depression.

There are several reasons for a denial of claims, according to disability attorneys. The most common are: failing to meet the definition of disability, failing to provide objective evidence, having a pre-existing condition, engaging in an act listed as a policy exclusion, failing to meet a contractual eligibility requirements, and/or misrepresenting yourself on the insurance application.

U.S. House Rep. Debbie Wasserman Schultz, D-Fla., heard about a report that ABC News did on wrongly denied claims and she says wants to pursue legislation that would penalize insurance companies if they wrongly deny claims.

“Right now there is no punishment,” Wasserman Schultz said. “I’m going to make sure that we pursue these insurance companies and make sure that they are covering the claims that they are supposed to until we can get this law passed.”

What makes this situation even sadder is that, websites like Long Term Disability Denials say that long term disability insurance carriers use often use stalling tactics to delay long term disability claims or flat out deny long term disability claims – hoping that long term disability policyholders will simply give up.

Some of the common tactics used are: sending policyholders the wrong claim forms, losing claim forms that were correctly submitted, interpreting the term ″disability″ inconsistently, using nurses to ″reapply″ restrictions and limitations without talking to your doctor or your employer about your job duties.

So, if you’re one of the thousands of policyholders whose long term disability insurance claim has been denied, do you have to accept a long term disability insurance claim denial? Absolutely not. Long term disability insurance lawyers say that you can, and should, question your insurance company’s decision – especially since so many long term disability insurers deny claims in bad faith.

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