Many LTD or long-term disability insurance cases get denied. But that doesn’t mean you should lose all hope.
Insurance companies aren’t in the business of simply handing out money to everyone who asks for it. They do their best to disregard and deny as many claims as they possibly can to make profits.
But, again, it doesn’t mean there are no chances of winning. Many denials go on to be successful wins. Therefore, you should go through the following and fight the insurance company for your benefits.
Getting an Appeal
When the insurer denies your disability claim, the first thing you should do is file an internal appeal with the insurance company. It’s essential to exhaust all the possible internal appeals processes before you think about going to court.
Go Through the Policy
In case you haven’t already, get a copy of the long-term disability claim policy. Also, get a summary of the plan.
To get this, you can get in touch with the HR team in your company or the insurer.
However, sometimes neither your company nor their insurer will just give you a copy of the policy.
In those instances, you must request the documents in writing. Write the request to the plan administrator at the insurance company and your employer’s HR team. Remember to send through certified mail with a return receipt request.
Understand the Denial Letter
Take your denial letter and thoroughly go through it to find out what happened. The letter should contain details of the reason why the insurance company denied your claim.
The denial letter may also contain details explaining the way you can file for an internal appeal. Remember: the deadlines are crucial.
Look Into Lawyers
Long-term disability claims can be a little tricky right from the start. That is why many people work with lawyers even when they are filing the initial claim.
If you don’t already, you should get an experienced disability lawyer as soon as possible. While you can get help from friends, family, acquaintances, or even the internet, only a suitable lawyer can properly assess your case and help.
Furthermore, insurance companies tend to take cases more seriously when a person’s attorney files them.
More Favorable Evidence
When you’re filing the internal appeal, you need to make sure you have every possible evidence that you can possibly get for your case.
Along with helping your internal appeal, this can be beneficial if you need to file an external appeal. That’s because you cannot present new evidence in court, only what you submitted during the internal appeal.
Get Medical Tests
Among the reasons for denial is the lack of objective evidence. If that is the reason, you should get in touch with your claims representative and ask them if getting more tests could help your case. These tests can be MRIs, blood tests, x-rays, or any other.
If they say yes, you should get as many relevant tests as you possibly can for the appeal.
Chase Missing Records
There is also a possibility that the insurance company and the plan admins failed to acquire all the necessary medical records that relate to your claim.
Therefore, you should look into the documents that were used to decide your initial claim. Your disability attorney should be able to tell you whether or not there are missing records.
Request Testimonies
You can also get some non-medical evidence to help with your appeal.
This can include written testimonies from your friends and family that describe your limitations. You can also have testimony from a qualified vocational expert. A vocational professional knows the types of jobs a worker with impairments can perform.