What is long-term disability insurance?
As the name implies, long-term disability insurance is for the duration of your disability or until you turn age 65 (age 67 in newer policies). Long-term disability insurance pays a percentage of your salary if you are not able to work due to sickness or injury. Most long term disability insurance policies provide you with a monthly benefit equal to 60% of your wages, or a predetermined fixed amount per month. The benefit will vary depending on whether you purchase an individual insurance policy or you are covered by a group insurance policy through your employer.
But you should pay close attention to the insurance policy limitations. While many long term disability insurance policies provide benefits if you are disabled from your job, these benefits are limited to two years. Then you only receive benefits if you are disabled from any job. Long term disability insurance policies also limit benefits for pre-existing conditions, mental/nervous disabilities and self-reported conditions such as pain and fatigue. Finally, beware of deductions (offsets for other income) to your long term disability insurance benefits. The majority of group long term disability insurance policies will reduce your long term disability insurance benefits by the amount of your Social Security disability benefits. Again, it’s crucial that you read the policy to know your Insured Rights.
To avoid interruption in your income, the key is to file your application as soon as possible – don’t delay.
Feeling frustrated and uncertain in dealing with a long term disability insurance claim is normal. The insurance policies are confusing and hard to read. The insurance company claim representatives are not much help and often make things more confusing and frustrating. This is no accident.
Insurance companies do not make money paying long term disability insurance claims. That is why they put hurdle after hurdle in your way, from requesting more and more information to simply delaying a decision. With each hurdle, the insurance company is counting on you giving up or missing a key deadline. Either way, the insurance company avoids paying your long-term disability insurance claim. The stress and uncertainty that comes with this process can be daunting. It doesn’t have to be that way.
Let an experienced attorney guide you through the long term disability insurance claim maze.
You should have access to the most experienced legal representation when fighting a long term disability insurance claim. We provide you with an initial free consultation with our experienced staff. Our goal is to eliminate your stress and anxiety while working to obtain a positive outcome. We strive to provide each client with personalized and reassuring guidance. At Grabhorn Law, while practicing law is our profession, helping protect your Insured Rights™ is our passion.
Filing A Claim
Time is of the essence – Do not delay filing your long-term disability claim. Here are some helpful tips.
Review the Insurance Policy.
Make sure you get a copy of the insurance policy (ask for it in writing and read it). If you have questions about the policy, ask the insurance company.
Cooperate
… with the insurance company. Complete their forms. Do what they ask you to do.
Do everything in writing.
If you can’t, then make sure to keep a log of who you talked to, (date, time, phone number), and what you discussed.
Ask questions about other benefits.
Ask the insurance company if you are eligible for any other insurance benefits, such as long term disability or life insurance waiver of premium. If so, ask what you need to do to file a claim for those benefits.
Ask what else is needed for your claim to be approved.
Do this in writing and repeat it in every letter you send to the insurance company.
Filing An Appeal
Time is of the essence – Do not delay in filing your long-term disability appeal. Here are some helpful tips.
File Your Appeal.
Generally, you only have 180 days in which to file. If you fail to file an appeal, you may lose your right to your benefits.
Ask for a complete copy of your claim file …
… including a copy of the insurance policy. Make sure to review these completely and correct any errors when you file your appeal.
Prepare your evidence.
Get a copy of your medical records from your doctors. Make sure your doctors have noted your limitations and restrictions that prevent you from working, including any side effects from your medication. If possible, have the doctor or medical examiner review the claim denial letter and comment on why they disagree.
File your appeal in writing …
…and provide additional evidence supporting your claim. Even if you only submit a one-page note stating you appeal, make sure you file the appeal.
Ask the insurance company what else is needed for your appeal to be granted.
Do this in writing and repeat it in every letter you send to the insurance company.
Filing A Lawsuit
Time is of the essence – Do not delay in filing your long-term disability lawsuit. Here are some helpful tips.
Do not delay.
There are strict deadlines for filing a short term disability lawsuit. The insurance policy may limit this time period, as well as state law. Time is not your friend.
Do not be afraid of filing a lawsuit.
It’s your legal right. Yes, it may take time, but it’s the only way to obtain the short term disability insurance benefits you are owed. If you use an attorney, you can be involved as much or as little as you like. Your attorney should make the process as smooth and stress-free as possible.
Look for an experienced law firm.
Not every law firm has experience with short term disability insurance claims. Make sure the law firm you choose has experience in dealing with not just your short term disability claim, but also with your medical condition and your insurance company.
Look for a law firm willing to try your case.
Although the majority of short term disability lawsuits resolve prior to a trial or judgment, if your case does not, you need to make sure you have a law firm experienced in successfully pursuing a short term disability lawsuit to a final decision.
Location should not matter.
You should not limit your choice of an attorney based on whether they are located near you. The most important factor should be experience, followed by your comfort level. With today’s technology, you should have the best of both – experience and comfort.