What the insurance company doesn’t want you to know about long-term disability claims

People who are disabled from working face the burden of financial uncertainty in addition to the pain of their illness or injury. If you have a long-term disability policy you can make a claim for benefits to tide you over until you are well enough to go back to work. However, claimants will be shocked to discover that many insurance companies consistently deny claims for reasons that are not valid.

Disabling conditions can be caused by a number of reasons as set out in the details of your policy. This type of insurance is designed to pay benefits should the individual become disabled from doing his or her job for an extended period of time. Depending on the type of policy you have, certain disabling conditions may be eligible for benefits while others are excluded.

Who is eligible for long-term disability benefits?
Only people who have purchased their own long–term insurance policies or those covered under an employee benefits plan are eligible to receive these benefits.

Others who are disabled to the extent that they are prevented from working can apply to CPP for benefits

How does it work?
When your short-term disability payment period is over, you can claim long-term disability benefits. Benefit payments are usually a percentage of your regular salary and will be payable for a specific term, or until, you are well enough to go back to work. The percentage and term of your benefits will be explained in your particular policy.

Things don’t always run smoothly
Unfortunately just because you or your employer has been paying disability insurance premiums, things do not always run smoothly when you go to collect. Even if you meet all the criteria set out in the policy fine print, there are no guarantees that your claim will be granted. Many applicants fail to receive benefit cheques, in a timely way, or at all. It is a common practice among insurance companies to deny or delay paying out the benefits their clients have paid for and are counting on.

What reasons do insurance companies give, to deny benefits? 

• Insurance companies deny claims for a variety of reasons including:
• Failure to supply sufficient medical proof
• Failure to complete application correctly
• Failure to submit application on time
• Missing information
• Incorrect information
• Misleading information
• Lack of diagnosis

Discrepancies between independent medical reports done by the insurance company and the medical reports done by your doctor. Your disability or illness is not eligible under the terms of your insurance policy. You are not disabled from doing certain parts of your own job (so you can still work). You may be disabled from doing your “own job” but you are not disabled from doing “any job. (so you can still work)

It is depressing and demeaning
Many long tern disability claimants are made to feel personally responsible for being denied. They end up feeling that they are somehow to blame for their disability. In a state of exhaustion and overwhelm it is no surprise than many claimants give up. Sometimes claimants appeal over and over, yet are continuously turned down.

If your long-term disability claim has been denied, do not panic.

For many insurance companies the first response is to deny or delay claims even when they are legitimately eligible for benefits. This style of doing business has become common process with insurance companies. They are practiced and good at it. They hire professional lawyers and medical staff to work on their behalf, then use these their reports against you.

Do not be surprised if they ignore your calls or stall on getting back to you.   The long delay time gives them more time to pad your file, (with their biased information) or to look for reasons why they do not have to pay benefits.  They often take this opportunity to do surveillance, or watch you on Facebook or other social media. If they can put you off long enough, the time limit for launching a lawsuit will have ended. And you will have no legal recourse to fight for your rights.

You need to make it clear you will not give up. You must get help from someone who understands the myriad ways insurance companies wrongfully avoid payouts. Disability Insurance lawyers understand insurance laws and ably decipher the legal jargon on policies. They can fight legal points toe to toe with insurance companies. They are familiar with the tactics and excuses insurance companies use, and can beat them at their own game.

You need someone on your side, who knows the ropes. This is not a fight that yo are likely to win going it alone.