The ideal time to consult an experienced attorney about a disability insurance claim is when an insured first begins contemplating filing the claim—several months or even years before actually doing so. At that point, we are able to advise clients about their policy language and requirements, review financial material and medical information relevant to the claim, and discuss inappropriate tactics that could be used by the carrier to not pay the claim. Our aim is to make the eventual claim process as seamless as possible.
We analyze complex disability insurance policies and scrutinize the specific definitions of key terms relevant to coverage. Disability provisions vary greatly, and coverage is often circumscribed and restricted by qualifying words and phrases. By understanding the specific implications of each individual policy, we are able to identify potential coverage issues from the start, enabling us to protect the insured’s rights to benefits before a claim is even filed.
Most disability insurance policies require that the insured seek regular medical care for a condition. If necessary, we assist clients with the process of finding the most qualified physicians who can best treat, understand and document the insured’s condition—an especially difficult task when doctors are busy or where the condition is predicated on subjective evidence. We work with clients to ensure that accurate and complete documentation of their disability exists in the event they must file for benefits. We correspond with experts, review our client’s medical records, and advise them on how to communicate with their treating physicians to ensure that their disabling conditions are appropriately documented.
We also advise clients how to operate their professional practice when contemplating a disability insurance claim in light of ethical and financial concerns. We review tax records, profit and loss statements, schedules and CPT codes to capture precisely how the client’s “occupation” will be defined at the time of claim. We analyze and document any professional incidents related to our client’s disability and advise them on what types of work they can and should perform. If clients are considering selling their practice, we counsel them on the timing of the transition, the terms of the buy/sell agreement, and how to structure employment or consultation agreements in order to get the best price for the practice and still file their legitimate claims.