Insurance companies can be a mixed blessing. In fact, legions of claimants across the country view them as akin to a double-edged sword.

Here’s why: Sometimes they perform, and sometimes they intentionally respond to claims designed to delay or deny the claim outright.

What explains the inconsistency in how the treat legitimate claims, and how often do such tactics occur?

The first part of that question is quickly and simply answered, to wit: Insurers want to make money, not spend it. It is standard business practice for companies to avoid paying out on claims to the extent they can do so without incurring legal liability.

We note on our website at the national pro-claimant ERISA Law Center that, “Most companies will pay most obvious claims.” That means a timely and response to obvious disabilities like cancer treatments and ALS.  Additionally, many insurers will grant claims that are expected to have relatively short durations.

It is generally longer-term disability cases that are problematic. Many LTD claimants experience blow back from their carriers in claims that involve lengthy time periods. They can also reasonably expect resistance in many instances concerning matters like this:

  • Conditions claimed upon that are not clearly obvious and where symptoms might be variable (e.g., chronic fatigue syndrome)
  • Conditions where a clear diagnosis lacks
  • Conditions where it can be argued that symptoms link primarily to medications and sleep disturbances

Confronting challenges from an insurer in a long-term disability claim is far from rare. Individuals having concerns regarding interactions with a long term disability carrier can reach out to an experienced ERISA disability attorney for guidance and advocacy.