Securing long-term disability (LTD) benefits can feel overwhelming. Those looking to get these benefits can help manage this frustration by having a basic understanding of the steps involved. Although the exact process may vary depending on the details of your policy, it often includes the following:
- Notification and Proof of Claim: After experiencing a disability, the claimant must notify their insurance provider about their intent to file for LTD benefits. This is typically followed by submitting a completed claim form along with required medical evidence and documentation related to employment and salary.
- Waiting Period or Elimination Period: Most LTD policies include a waiting or elimination period, which is the time between the onset of disability and when benefits begin. This period can range from 30 to 90 days, or longer depending on the policy. It is extremely important to watch for these timelines, as a failure to take appropriate steps within this timeframe can make it more difficult to move forward with your claim.
- Assessment by the Insurance Provider: The insurance provider assesses the claim to verify the disability and determine eligibility under the policy terms.
- Approval and Commencement of Benefits: If the claim is approved, the insurance provider will start disbursing benefits, usually calculated as a percentage of the claimant’s pre-disability earnings.
- Ongoing Evaluation: The recipient may be subject to ongoing evaluations to confirm that they remain eligible for benefits under the terms of the LTD policy.
Unfortunately, insurance providers often take steps to make it difficult for the applicant to receive their benefits. In a recent example, Hartford Life and Accident Insurance Company attempted to shut down a lawsuit, claiming it was still considering the application at the time of the filing. The court disagreed, stating that the insurance provider had taken too long. Such stalling tactics are not uncommon, and it is wise for applicants to be prepared for these types of attempts.
Insurance companies may also try to deny a lawful claim. They may argue that the applicant provided insufficient medical evidence to support the claim or that they do not meet the definition of disability as per the specific LTD policy. Those who find themselves in this situation have options, most notably to appeal the insurance company’s denial.
Applicants who find themselves in this situation are wise to meticulously gather all necessary documentation, adhere closely to the policy’s requirements, and seek professional advice when needed. Understanding the legal aspects and preparing for potential challenges can make a crucial difference in securing the benefits needed for long-term support. Remember, persistence and knowledge are key in navigating the complexities of LTD claims and appeals.