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Your Erisa Benefits

What should I do if my disability insurance provider denied my claim?

On Behalf of | Apr 15, 2022 | Erisa, Long Term Disability Claim Denial

Insurance is supposed to provide a safety net, a helping hand when we are need. We may get coverage from our employer or with an independent policy but in either case we expect the disability insurance company to actually provide coverage when we have a claim.

Unfortunately this is not always the case. Policyholders may find themselves dealing with an unexpected denial. If you find yourself in this situation, you are not alone. The National Association of Insurance Commissioners (NAIC) report that the top three policyholder complaints involve denial in processing, unsatisfactory claim amount or improper denial of the claim. These complaints make up over 45% of all complaints about insurance reported to the organization in 2021.

What happens when the insurance company refuses to cover our claim?

The answer generally lies within the language of the policy. In most cases, those who believe their insurance company has wrongly denied or underpaid their claim can hold that company accountable through an appeal.

Policyholders can use the following tips to help build their case:

  • Review the policy. Look over the language of the policy to better understand your rights. Look for information about what is covered and how to file a claim as well as your rights in the event of a dispute.
  • Gather records. Keep copies of healthcare bills as well as details about conversations with anyone who works with the insurance company. This should include who you spoke with as well as the time, date, and highlights of the conversation.
  • Do not give up. The process can be frustrating, but those who stay on top of their insurance provider with frequent follow-ups are more likely to get the funds their entitled payment.

An aggressive approach is often the best solution. Victims who are fighting for their disability benefits do not have to go through the process alone. An attorney experienced in this specialized area of the law can help navigate the system on your behalf and better ensure you get your benefits.