Important Long-Term Disability Alert!
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Fighting Back Against Long-Term Disability Denial
Falling seriously ill or sustaining significant injuries can make it impossible to support oneself with a normal career. This may lead to a vicious cycle in which those without the means to work lose the income needed to pay for prompt recovery and therefore fall into progressively deeper debt. While long-term disability insurance is specifically designed to help people avoid these negative outcomes, insurers aren’t always willing to step up and fulfill their obligations.
Important Warning Video
Understanding Insurance Denial
As per most policies, the majority of insurers retain the right to deny claims. Even if an injury victim, accident survivor or medical patient has a valid legal reason for seeking disability insurance, their policy provider may resist paying on any one of multiple grounds.
Insurance providers can deny claims on grounds like the existence of prior medical conditions regardless whether claimants properly paid their premiums before the events in question. This only exacerbates the ongoing financial issues faced by those in need of disability payouts.
Examining Policy Terms
The exact nature of a given insurance policy’s coverage can be confusing. This lack of clarity may lead some claimants to assume their insurers were right in denying them. Taking a closer look at how disability insurance is supposed to work, however, often sheds light on the rights policyholders are entitled to exercise.
What’s Usually Covered?
Long-term disability coverage isn’t just for workplace injuries. In fact, more than 90 percent of such claims have absolutely nothing to do with on-the-job incidents. Instead, the majority relate to illnesses like cancer, degenerative diseases and other debilitating medical conditions that are commonly eligible for coverage.
It’s important that each claimant understand the specific terms and clauses in their policies. Although many appear to be boilerplate legalese, most insurance contracts are customized to the needs of the individuals they serve. Different state laws and regulations also impact the kinds of coverage that are permissible and the actions providers may take.
The Claims Process
Due to the unique nature of each situation, filing a successful claim and appealing denial letters require attention to detail and legal experience. The best course of action also varies depending on how each case has progressed.
In some cases, insurers act in bad faith by delaying claims. Because they haven’t actually denied the claimant, the victim lacks the legal grounds to appeal. Insurers may also disburse insufficient or incomplete payments, incorrectly classify injuries or fail to notify policyholders that they’re owed certain benefits.
Some insurers outright send denial letters in response to claims. As official as it seems, this could be another form of bad faith if insurers lack legitimate reasons for their refusal.
What Can Policyholders Do?
Victims don’t have to settle for their claims being denied, delayed or otherwise mishandled. In most cases, insurance laws provide some form of legal protections. To find out if you’re eligible for compensation and discover the smartest next steps, get in touch with Pulaski Kherkher PLLC today.
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