This is a provision that requires a claimant to be under the care of a doctor in order to receive disability benefits. Initially, care provisions simply required you to be seeing a doctor on a regular basis in order to retain your eligibility for benefits. However, over time, insurance companies have made care requirements much more stringent, in an effort to dictate policyholders’ medical care and force policyholder’s to undergo unwanted procedures. So, for example, if you have a newer disability policy, your policy might add the additional requirement that you must receive the “most appropriate” care for your condition in order to keep receiving your benefits. If your policy contains such a provision, and you disagree with your insurance company’s opinion of the “most appropriate” care for your condition, you may be forced to choose between submitting to an unwanted medical procedure or going to court to resolve the dispute.
Click here for more information about the different types of care provisions and how they impact your right to make your own medical decisions.