Disability Claim Denial and What You Can Do
There are many instances when insurance companies deny long-term disability claims, but that does not mean that you should give up hope of getting your compensation. There are many cases where an initially denied claim is later accepted. Therefore, if your long-term disability claim has been denied, one of the most important things you need to do right away is understand what went wrong with your claim and why it was possibly denied before making an appeal to challenge the denial.
To participate in this lawsuit you must meet the following requirements:
- You must have been denied by one of the following insurance companies: Aetna, Aflac, AXA, Cigna, Genworth, Guardian, Hartford, John Hancock, Liberty Mutual, Lincoln Financial Group, Mass Mutual, MetLife, Mutual Of Omaha, Northwestern Mutual, New York Life, PAL, Paul Revere, Provident Life, Prudential, The Standard, State Farm, Transamerica or Unum Provident.
- You must have been denied after 2008.
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Why Disability Claims are Denied
Before you make an appeal, it is important to understand why your claim was denied in the first place so that you do not make the same mistake again. Here are some reasons why your claim could have been denied by the insurance company:
- There were procedural or clerical errors because you failed to send all the required documents.
- You had a pre-existing medical condition at the time of buying insurance, which contributed towards your disability.
- You tried to misrepresent or manipulate information and purposefully tried to commit fraud.
- You do not meet the eligibility requirements that ware outlined for disability claim in your policy.
- The condition leading to disability was mentioned in your policy as excluded for receiving claim.
- You did not provide accurate or comprehensive details about your accident leading to disability.
- You failed to comply with medical treatment conditions.
- The surveillance results that came up in the insurance company’s investigations did not match with your description of the accident.
If the fault was on your part, you can make it right when making an appeal to ensure that you do not have a problem in getting the claim this time.
How to Make an Appeal
Now that you understand why your disability claim was initially declined, you need to make an appeal. For that, here is what you need to do:
- If you do not already have it, the first thing you need is the copy of the insurance policy you have. This should include a summary plan description so that you can understand what the terms and conditions of your policy exactly were.
- Next, you need to go through the denial letter to note down the reasons they have provided for denying your claim. Do your best to rectify the mistakes you made last time, especially if you submitted insufficient documents or information.
- Consider hiring a lawyer to represent you in the case as soon as possible. Not only would they know what to do to guarantee that your claim gets approved, but also insurance companies tend to take claims represented by lawyers more seriously.
Once you have all that in order, you can make your appeal in a court of law to claim your disability insurance. If you have done everything the right way, you will not be rejected, provided that you have a good lawyer to represent you.