Disability Insurance Claims – COVID-19 Complications

COVID-19 has impacted several aspects of our lives, and many things are much more complicated now. Disability insurance claims are no exception, as COVID-19 has raised additional hurdles for policyholders filing “own occupation” claims. Some of the most common questions and concerns physicians and dentists are facing include:

How long will it take to get a decision during COVID-19?

Typically, insurers can take several months to issue a decision. With many companies operating with limited staff, claim decisions may now take even longer.

Now, more than ever, it is important to be proactive about your claim. Extensive delay may be unreasonable, even during the pandemic. But it is not always easy to determine how long is “too long” to wait.  An experienced disability attorney can help you determine if your disability insurer is unreasonably dragging its feet, or if any action needs to be taken to ensure a timely decision.

What if I can’t get in to see my doctor?

Many policies have care requirements that require you to be actively treating with a physician.  This can be difficult when many doctors’ offices are working on a limited basis. Delays are common, due to the backlog of patients needing to be seen. Certain legal rules allow for delay if it would be unreasonably difficult for you to produce evidence within a required time frame—but these can vary based on your policy and your jurisdiction.

What if I can’t get records or paperwork from my treating providers?

Insurance companies will typically ask for medical records and statements from your treating providers to support your disability.  Because many doctor’s offices are operating at limited capacity, this can also be difficult. Again, depending on your policy and the laws in your jurisdiction, you may be entitled to flexibility when responding to these requests.

Do I have to let my insurance company conduct a field interview or IME?

Insurers often conduct at least one field interview during the course of a claim. Similarly, insurance companies may ask an insured to attend an independent medical examination (IME). Understandably, during this time, insureds are reluctant to be in close proximity with a stranger. An experienced disability attorney can help you determine whether these sorts of requests are reasonable under the circumstances.

The best way to handle these situations depends on the specific terms of your policy and local laws. In some instances, what the insurance company is asking for may be unreasonable, and therefore unenforceable. If you have a question about how COVID-19 has impacted or may impact your claim, please feel free to contact one of our attorneys directly.

 

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