Private disability insurance is supposed to provide you with the coverage needed when you are unable to work. However, it is possible for your provider to deny your claim. When this happens, you have the option of appealing or accepting the decision. If you are contemplating appealing, here is what you need to know.
Why Was Your Claim Denied?
There are a number of reasons that an insurance provider can choose to deny a disability claim. Knowing exactly why yours was denied is important. If you are aware of the reasoning, you can tailor your appeal to address the issue that the insurance company had.
For instance, claims are routinely denied for a lack of medical evidence. The insurance company could have been missing your medical records or the doctor's statement was not enough to convince your provider that you do have a serious impairment that prevents you from working. If a lack of evidence is to blame, you and your attorney would need to provide the insurance company with the information it needs to make a decision.
The reason for the denial should be included in your notice, but it is best to contact the insurance company directly. When you call, you need to not only ask for the reason that the claim was denied, but the section of the policy that allowed for the provider to deny your claim.
How Should You Start Your Appeal?
Once you know why your claim was denied, you need to read your policy. Although it can be time-consuming, you need to read the entire policy and not just the parts that pertain to your case. If the insurance switches tactics, you need to be prepared to handle it. Knowing your policy is the best way to be prepared.
You also need to collect as much evidence as possible to prove that you are entitled to benefits. In addition to providing your medical records, you need to contact the insurance provider and determine if there are additional tests that you could have performed that would help with determining whether or not you qualify for benefits.
If your doctor previously provided an opinion to the insurance company, ask him or her to write a more detailed accounting of your illness and impairment. If you have specialists that are also treating your condition, you need to provide opinions from them, too.
Your attorney (Iler and Iler is a great place to start) will help you collect other evidence to prove that you are entitled to disability benefits.Share