Many employers provide disability insurance benefits for its workers. We do. Short-term and long-term disability benefits are crucial to being able to pay living expenses for someone who is ill or injured and cannot work. Is the disability insurance company your friend?
The insurance company that is to pay benefits can make the claims process very confusing and difficult. The burden is on the applicant to prove disability. The insurance company does not have any obligation to make sure the claim is complete, including securing all medical records.
If the claim is not well supported, the insurance company does not have to pay benefits.
We represent people who are applying for or have been denied employer-provided disability benefits. Hurdles we frequently see in representing people seeking disability benefits provided by the employer, include:
- Denying that it has received certain medical records – even while the treating clinic has told the applicant they have been submitted to the insurer.
- Misstating the actual medical conditions – including minimizing the impact of a diagnosed condition.
- Denying that a person has disability benefits coverage — when it actually exists.
- Misquoting a treating doctor about a condition. The insurer will have its in-house ‘independent’ doctor call a treating doctor for ‘clarification.’ The insurance company doctor then misstates what the treating doctor reported. The bad information goes into the claim file and a claim is denied or benefits are terminated.
The list of insurance company methods to deny a proper disability benefits claim knows no end.
The insurance company is not your friend.