Many policies have a provision that limits coverage for disability benefits due to an illness or injury that is based on self-reported symptoms (sometimes referred to as “subjective” symptoms). These are disabilities that cannot be verified by medical testing. Common examples include headaches, pain, fatigue, stiffness, soreness, ringing in the ears, dizziness and numbness. Typically, benefits are limited to a period of 24 months.
Click here for more information about the challenges of disability claims involving self-reported symptoms.
Many policies distinguish between a disability caused by injury versus one caused by sickness/illness. Disability due to sickness is typically defined as sickness or disease that firsts manifests itself on or after the effective date of a policy, while it is in force. Under some disability policies, the amount and duration of benefits is determined based on whether a disabling condition is classified as an injury or sickness.
Click here to learn more about how your policy may treat disabilities due to sickness different than disabilities due to injury.
See Offset Provision.
Surveillance is a tool commonly used by insurance companies to collect information that they can use to deny or terminate claims.
Click here for more information about how insurance companies use surveillance to deny or terminate benefits.