An established and authoritative legal source on ERISA-governed disability applications and eligibility poses a prominent question on its website.
That is this: “How often do disability companies deny claims and appeals?”
Reams of both anecdotal and empirically vetted research supply a ready answer to that question: often.
Disabling conditions likely to confront insurer blowback
The above source duly notes that most insurers will be reasonable about paying the “most obvious claims” (cancer treatments, for example) of a short duration. They often balk, however, when it comes to fulfilling contractual duties relevant to many types of disabling conditions. Here are some examples:
- Disabilities that persist for lengthy periods
- Instances where a clear root cause is not readily agreed on among medical professionals
- Lack of a clear/concise diagnosis
- Where subjective disabling symptoms are featured, like pain, compromised sleep and fatigue
Why COVID-19 disability faces insurance coverage hurdles
A recent in-depth national media piece spotlights the challenges that many individuals diagnosed with disabling COVID-19 symptoms have when seeking to secure disability insurance benefits. It underscores that care providers are still “trying to figure the condition out” and that disability insurers are seizing upon uncertainty to deny or delay claims.
“Symptoms of long-haulers (individuals with persistent challenges) are wide-ranging and not always the same for everyone,” it notes. That makes “the condition difficult to pinpoint under a single profile.”
Applicants often confront material challenges when complying with disability insurance claim processes and demands relevant to claim approval and payment. But, they can turn to a proven national disability law firm for guidance and strong legal representation.