After paying your premiums for many years, now you need to use your disability insurance. You’ve done what you needed to do. Saw your doctor, got testing and treatments, filled out all the forms, and did everything they asked. But your claim was still denied. Now what?
Denial Is Not Final
The denial letter you receive is not the end of your claim, only an obstacle. You have options and can appeal the denial. Review your policy’s documents to understand what your next steps are.
A claim denial can happen for a number of reasons:
- Inadequate or incomplete medical records
- Written opinions from your treating physicians (this can be added during an appeal)
- Incomplete medical testing and/or treatments
Your application should contain as much favorable information as possible for a positive decision. Adding as much as you can in the claim application ensures that if during an appeal, no additional evidence can be added, you have more than enough evidence to begin with.
If your insurer has wrongfully denied you benefits based on an individual disability policy, you (or your family) may be able to recover lost benefits, wages, pain and suffering and other, similar damages.
Bad Faith
Insurance companies are in the business of making money, not paying it out. Disability insurers use a number of notorious tactics they use to prevent the payment of a claim, including:
- Policy termination without notice
- Long delays in their review process
- Mis-classifying injuries in order to deny a claim
- Hiding benefits from policyholders
- Excessive requests for documentation
- Complicated forms with badly defined terms
- Delaying your claim
- Changing due dates
The idea is that you will, after the first denial, simply give up your claim and leave them alone, or at least settle for less than you thought you would receive.
Options
If you’ve received a denial letter after applying for the first time, you are entitled to an appeal. This should be described in your denial letter. Pay attention to any dates or time period mentioned in the letter, because if you miss them, your appeal will be dismissed.
You have the right to ask for any and all documentation and expert advice that was used to decide your claim, without charge. You’ll be able to determine what information might have been missed, and hiring an experienced disability law attorney can give you the best chance of winning on appeal. Working with an attorney who understands the application and appeals processes will make sure that your application and any appeals will be completed, giving you the best chance of a successful outcome.
It’s never too early to contact a disability attorney for help. Whether you’ve just become disabled and are wondering about your options, have been denied benefits, are appealing, or just don’t have the stamina to deal with an insurer while you take care of yourself, contact a disability law attorney to help you stand a better chance of winning.
Let Herren Law Increase Your Chances Of A Win
If you’ve become disabled and unable to work, the last thing you need is to worry about how to pay your bills and keep your household going. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges. You don’t owe a fee until we win your case.
