Category Archives: Long-Term Disability

Essential Factors when Appealing for a Long Term Disability Claim

Long term disability due either to illness or injury can have a devastating effect on the financial life of a struggling family. Quite too often the disability benefit applied for by many individuals are turned down by insurance providers. The usual reason for such denial, as stated on the website of Scudder & Hedrick, P.L.L.C., is strictly technical, though, and not because of ineligibility; that is, improper filing of application or missing a signature or skipping a box when filling out an application paper – these errors sometimes happen because disability insurance policies are long and complex documents that can confuse applicants.

However, there are also reported instances when applicants are judged not qualified or, if approved, are awarded small payments. If long term benefits are meant to compensate for salary losses, then being awarded a small amount would never suffice for medical treatment alone, let alone the family’s daily expenses.

Many insurance providers resort to finding faults in applications aggressively and then deny claims or award small benefits to ensure increase in their profit. Besides using the guise of technical or paperwork issues, these providers also resort to other tactics to make denials appear legitimate, tactics like, misclassification of injuries, undue termination of the policy and delay in the approval and/or release of benefit.

Legal experts call denials of benefit as “insurance bad faith,” which is a breach of the contract that providers, themselves, made and which they signed with the policy holder. If an insurance company, though, denies any long term disability benefits claim, then the applicant must be allowed to a full and fair examination of the denied claim, as well as to appeal the decision.

An appeal is a formal petition that asks for a re-assessment of an unfavorable decision (like a denial, termination or reduction of benefits) made by an insurer. To avoid losing an appeal, some important factors that claimants ought to consider are:

  1. Preparation of relevant documents like medical record, medical expert opinion, letters from employer, medical abstract and photographs
  2. Awareness and readiness to argue against an insurer’s inadequate in-house medical review, misrepresentation or misuse of evidence
  3. Filing the appeal before the set deadline

Equally important as those above is having a highly-skilled and determined legal counsel who will represent you and fight for your rights throughout the appeals process. A less qualified lawyer may cost applicants the long term disability appeals they have worked hard to prepare for.

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The Need for Long Term Disability Claims Filing Assistance

It is not at all easy to make a claim for long-term disability from an insurance company, whether employer-provided or personal. Because the claim is based on a person’s capacity to work, there is quite a burden of proof on the claimant and the language of insurance is (deliberately) obfuscated. In other words, mere mortals may have difficulty in understanding what is being said, or the requirements for properly making a claim. This is where lawyers can be of great help in providing long-term disability claims filing assistance.

According to the website of Scudder & Hedrick, PLLC, in Raleigh, North Carolina, insurance companies are always on the lookout for any opportunity to delay or deny a claim. Filing a claim without knowing the process can easily lead to the ultimate denial of legitimate long-term disability benefits. This is a major problem for someone who is unable to work and has many financial obligations. It is essential that the utmost thoroughness and care is taken when filing a claim for long-term disability with an insurance company. The documents provided to back up a claim has to be complete and properly filled out so that there are no loopholes that an insurer can use to wriggle out of its obligation.

It all lies with how an insurer defines “qualified” claims. The terms of the policy will set out what the limits are as well as who are eligible to receive benefits. An unchecked box, misplaced period, or uncrossed T can shoot holes in a claim that would otherwise be perfectly legitimate. Long-term disability claims filing assistance lawyers are well-versed in the steps for this particular dance with insurance companies, and will not hesitate to aggressively defend a client’s rights.

If you need to file a disability claim with your insurer, you would do well to consider getting long-term disability claims filing assistance at the very beginning to avoid derailing your case. Find a lawyer in your area with the requisite experience and be assured that you will be given every chance for a successful claim.

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