SERVICES - Disability Insurance Lawyers

What is Disability Insurance?

Disability insurance is a form of health insurance. It is income paid to you by your insurance company when you can’t work due to sickness or accidental injury. Disability insurance income replaces either a portion of your regular income or is a set dollar amount. Benefit periods and amounts may depend on whether the disability was caused by an accident or illness and whether the disability is ‘short term’ or ‘long term.’

Disability Insurance Claim Issues

Disability insurance should provide peace of mind in the event that you are disabled and require replacement income. Unfortunately, this does not always happen. Paying disability insurance premiums does not guarantee that a claim will be paid. In many cases, claims are denied or stopped as a result of:

• Failing to Meet Definition of Disability – If the insurance company feels that you are able to perform your job duties, your claim may be denied as you did not meet the insurer’s definition of “disability.”
• No Objective Evidence – If the insurance company cannot find objective proof of the existence of an illness or injury through diagnostic testing (MRIs, X-Rays, CAT Scans, etc), it may deny your disability claim.
• Pre-Existing Condition - A disability is deemed to be ‘pre-existing’ when the person filing the disability claim suffers from the same medical condition before becoming insured under the policy.
• Policy Exclusions – Long-term disability claims will often be denied if the disability results from intentional self-inflicted injuries, criminal activity and/or drug and alcohol use.
• Contractual Eligibility – Eligibility to receive disability insurance may be subject to timelines. For example, a person may need to be employed for a certain time period (i.e. 3 months) before being eligible for coverage.
• Misrepresentation on the Application – A disability insurance claim may be denied if the insurance company feels that a claimant was not truthful, or failed to disclose critical medical information on his/her application.