It shouldn’t come as a surprise that long-term disability claims cost insurance companies a great deal of money. It’s why they work so hard to find reasons to deny those claims. Though you see them as benefits that are rightfully yours, those that you contracted for and paid into, insurance companies see the payouts as hits to their bottom line. And they will do whatever is necessary to protect that bottom line. After a person files a long-term disability claim with their insurance company, they use whatever means possible to delay or deny that claim. Facing no penalties for doing so, the winner will always be the insurance company, at least in the short term. But it is usually during this initial time where the claimant is hit hardest with medical bills and lost wages. Many rightful claimants have faced bankruptcy, the loss of their home and any savings that they may have had. Understanding the tactics employed by disability insurance companies is imperative to avoiding the pitfalls that the insurance company creates in order to protect their profit margins. Be aware that insurance companies will employ the following in order to deny your claim:
- Delaying your case as long as possible. Even if your insurance company delayed making a decision in regards to your claim, they are not liable for paying any penalties or any other fees to you; regardless of your losses. They will simply be required to pay what they owe you. Therefore, it is in their best interest to delay as many times as possible. You can protect yourself against this tactic by understanding and adhering to the process of filing a claim and by remaining in contact with your insurance company on a regular basis.
- Hiring medical professionals to find discrepancies in your claim. With a team of doctors and nurses on staff, who are employed for the sole purpose of reading your medical records and reviewing diagnostic medical tests, insurance companies arm themselves with knowledge of your case to use against you. Even though they may just use a small bit of the records, it is with the intent to deny you of your benefits. Providing complete and factual records that comprehensively cover your medical history and your symptoms can help you fight against this tactic.
- Employing video surveillance. With today’s surveillance technology making it extremely easy and inexpensive to monitor someone without their knowledge, all insurance companies use this widespread practice. No longer do they need to use a surveillance van to record your every move. That guy walking his dog past your house twice a day, that you just happened to bump into at the grocery store? He very likely could be an employee of the insurance company that you filed a long-term disability claim with. Though it is understandable that you may have good and bad days with your illness or injury, understand that your insurance company will only use the proof of your good days as evidence for denial. You can fight this tactic by making sure that your medical records reflect the fact that you will have days where you feel well and that normal activities can be expected.
The ERISA Law Center represents claimants in all stages of their group disability or life insurance claim. From claims monitoring to appealing to buy-outs, ERISA Law Center guides you through the legally challenging world of group benefits and ERISA appeals. ERISA Law Center is also prepared to defend your win in appellate courts or, if appropriate, to try to overturn your loss to help you recover benefits.