Protecting Your Benefits

Many doctors (and lawyers) unfamiliar with professional disability insurance claims assume that the initial filing is “the claim” and an initial claim approval is “the win.” But obtaining a favorable claim decision is only the beginning.

Most “own occupation” disability policies pay monthly benefits, which means that your claim can (and is) constantly reassessed on a monthly basis for the lifetime of the claim. Most disability policies (particularly newer, post-2000 policies) also grant the companies broad investigative powers, including the right to require you to undergo medical exams at any time, appear for an in-person interview at any time, produce financial information (like your taxes) at any time, and the list goes on.

Oftentimes, companies will go away and leave you alone for a time, in the hopes that you become complacent. They may stop asking for reports and/or calling you as often, while continuing to gather medical records, talk to your doctors, and/or conduct surveillance (both online and in-person) behind the scenes.

If you have never been involved in a disability claim before and don’t have industry knowledge about how these companies operate, it can be very difficult to gauge whether your company is overstepping and/or targeting your claim for denial.

Because your insurer can revisit, challenge and deny your claim at any time, our attorneys continue to monitor our clients’ claims throughout the entire course of the claim. We require all requests for information to be handled through our office (including contact with treating doctors), so that we can evaluate whether the requests are appropriate and identify and address bad faith tactics before they result in a claim denial.

We also advise clients on how to handle the myriad of other obstacles that insureds must often overcome to receive disability benefits, including in-home interviews with claim agents; medical record reviews; psychiatric evaluations; Functional Capacity Exams; audits of individual and practice tax returns, insurance filings and billing records; demands for precise time quantification; and video and internet surveillance. Our disability insurance attorneys monitor the insurance company’s every step to protect against unreasonable delays, undue harassment, or misconstruing of information in processing clients’ claims for disability benefits.

Overturning Claim Denials