Disability Claims in Today’s Economy

Filing a private disability insurance claim in this economy can be daunting. Insurers now have more incentive than ever to deny payment of “high-end” claims, like those filed by medical, dental or other professionals. However, a few guidelines can help you protect your benefits in these difficult times.

1. Understand Why Insurance Companies Feel Pressure to Deny Claims

Disability claims filed by physicians, dentists, and other professionals can be expensive for insurance companies to accept. The troubled economy and the rising number of disability claims filed by professionals have led to financial hardship for the disability industry. This strain on resources creates an incentive for insurers to deny these expensive claims. Thus, many insurers closely scrutinize the terms of professionals’ policies in order to find ways to deny benefits, as the long-term financial benefit to the insurance company is significant.

2. Know Some Basic Policy Terms

An “own-occupation” policy provides compensation following a disability that prevents the insured from performing the particular duties of his or her occupation. If an insured professional does not have an “own-occupation” policy but an “any occupation” policy, he or she must be disabled from performing the duties of any occupation for which he or she is reasonably qualified in order to receive benefits. Some policies are a hybrid, providing own-occupation benefits for a limited period of time, then converting coverage to the “any occupation” standard.

3. Contact an Attorney Well Before You File Your Claim

Those who are considering filing a claim for disability insurance benefits should meet with an attorney experienced in the area well-before submitting a claim for payment. Each disability policy has different, complex language that insurance companies may manipulate to circumscribe and restrict coverage. Insureds should make a coordinated effort with the assistance of a lawyer to determine whether their particular claim is covered and, if so, how that claim is best presented to ensure payment.

4. Select the Right Firm to Represent You

Look for a firm that can help from the beginning of the process by analyzing complex applications and policies and identifying potential coverage issues. The best firms have particular skill in documenting claims, completing claim forms and communicating with treating physicians. Once the claims process begins, a firm should be able to protect clients against unreasonable delays and abuse by the insurer. You should also seek a firm that provides knowledgeable advice and practical guidance on how to best handle an Independent Medical Examination or other testing that may be required by an insurance carrier.

Though filing a disability insurance claim in a recession can be overwhelming, the challenges involved are not insurmountable. By following the guidelines above and enlisting the help of a qualified attorney, you can protect your future in any economy.