When you are unable to work due to an injury or sickness, you should be able to collect disability insurance provided by your employer or privately acquired coverage. Insurance companies can and do refuse coverage for a number of reasons, even if you have the help of a disability lawyer.
When coverage is rejected, many consumers do not appeal the insurer’s decision. It might feel as if the playing field isn’t level. You can successfully appeal disability insurance denials if you have the necessary knowledge and preparedness.
Here is a look at four reasons why long-term disability claims are denied.
1. Not Enough Medical Documentation
The insurance company contends that you haven’t given enough medical evidence to back up your disability claim. When it comes to medical paperwork, the rejection letter is full of intimidating details: it appears official, there’s a lot of information, and you’re nearly always given the option to appeal the decision. This letter alone is considered an intimidation technique, and the receiver may be discouraged from proceeding.
2. Surveillance Shows You Are Not Disabled
Insurance firms frequently use private investigators to conduct surveys of people in their daily lives. It’s a tool in an insurance company’s toolkit, but it shouldn’t be the only reason you’re being turned down.
While the surveillance is ineffective, claimants may feel nervous about the prospect of being watched. “We caught you walking your dog,” they may add in a letter describing what the surveillance captured. But let’s say that you’re depressed. What difference does it make whether you’re walking your dog?
3. Not Dealing with Total Disability
Many people with the aid of a disability lawyer like Disability Lawyer Toronto must fight for what they claim is a total disability. This is where their disability is so severe that it prevents them from going back to work or life as it was before they became disabled. The important thing to note in the cases of these kinds of denials is that total disability is not a legislative term. It is a term that was dreamed up by the insurance industry.
For those of you who are new to disability and all of its ins and outs, let’s break down what total disability means before moving on to the next reason why a claim is denied. In the case of a long-term handicap, you cannot perform the fundamental functions of your employment or any other occupation for which you are qualified by training, education, or experience.
4. Insurance Companies Medical Team Doesn’t Think That You Are Disabled
The following is an example of what a case may look like if it were to go to court: Your own physician, who has been treating you for years, as opposed to an insurance company’s in-house or contracted “expert,” who may have spent less than an hour with you during your visit.
Who do you think that the court would believe? Your doctor will be able to give more accurate documentation of your condition than the insurance companies consultants.