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Common Reasons Disability Claims Are Denied

Frustrated Injured Woman Looking at Laptop

You have disability insurance to protect your loved ones should you become disabled and can no longer earn a living. It is important that you understand the most common reasons disability claims are denied before purchasing a policy.

You Filed for Benefits Too Late.

Long-term disability insurance policies require that you file a claim within a specific time frame. Should you fail to file within the time limits, the insurance company may deny your claim. It is imperative to understand the time limits for filing a claim in your policy.

You Failed to Answer Questions from the Insurance Company.

If your benefits were approved, the process doesn’t end there. The insurance company will be monitoring your progress and will have health questions over time. If you fail to answer any communications from your insurer, the company may terminate your benefits.

Pre-Existing Conditions Exclusions

A common reason disability claims are denied is the result of a contract clause regarding pre-existing health conditions. The clause may deny benefits if a claim is submitted within the first year, or when they believe your health condition existed prior to purchasing the policy. The insurance company will investigate your medical records to determine whether you had undergone medical treatment that proves your health condition existed before purchasing the disability insurance policy.

You Failed to Get Required Medical Treatment

You may be required to undergo medical treatments to be eligible for disability benefits. If you do not have specific treatments, the insurance company may deny benefits. The company may also require you to have an independent medical assessment. Every policy has a different legal language, and you need to understand your responsibilities regarding medical treatments or an independent assessment of your health condition.

Definition of Disability Requirements and Employment

Each policy defines disability differently. In a group disability insurance policy, it is typically necessary to be disabled in a manner that makes it impossible to perform the duties of that specific occupation for 24 months. After the 24 months have expired, it may be necessary to be assessed to see if you can perform the duties of another job for which you are sufficiently educated, trained, and experienced. If the insurance company decides you have the capacity to work in another profession, they may deny further benefits.

The Right Disability Insurance Policy – The Small Print Matters.

When considering purchasing a disability policy, it is vital that you understand what the policy provides in benefits, and how to file a claim for benefits. When you work with a local insurance agent, you can gain an understanding of what each policy will and won’t do for you if you are no longer able to work and earn a living. These policies can protect you and your family from financial ruin should you become incapacitated due to illness or a serious accident, but the details of the policy are of ultimate importance – talk to an insurance agent before deciding.

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