Disability Claims in Today’s EconomyApril 4, 2011 | Disability Claim Denials, Filing Disability Claims
In this economy, filing a disability insurance claim can be daunting. Insurers have a strong incentive to deny payment of “high-end” claims (such as those filed by medical professionals) in order to protect their bottom line. A few tips can help to protect your benefits in these tough times:
1. Understand Why Insurance Companies Feel Pressure to Deny Claims
Some of the most expensive disability claims are those filed by physicians, dentists, and other professionals. The troubled economy has hurt insurer’s earnings on their investments, while at the same time the increasing number of professionals’ disability claims means that the insurer increasingly faces a financial squeeze. The easiest thing to do is to deny the most expensive claims. Thus, many insurers closely scrutinize the terms of professionals’ policies in order to find ways to deny benefits, as the long-term financial benefit to the insurance company is significant.
2. Know Some Basic Policy Terms
Own occupation policies provide compensation for a disability that prevents the insured from performing the particular duties of his or her own occupation. Any occupation policies require that the insured be disabled from performing the duties of any occupation for which he or she is reasonably qualified in order to receive benefits. Some policies may combine both of these, paying own occupation benefits for a period of time before converting coverage to the any occupation standard.
It is important to consult with an experienced attorney before submitting a claim for payment. Each disability insurance policy has different and complex language which the insurer may manipulate to reduce coverage. Insureds should make a coordinated effort with the assistance of a lawyer to determine whether their claim is covered and if so, how to best present it for payment.
Look for a firm that has the capability to assist from the beginning of the process by analyzing complex applications and policies and identifying potential coverage issues in advance. A law firm with a track record in claim documentation, completing claim forms, and properly communicating with treating physicians is essential. A firm must also be vigilant throughout the entire process to protect clients against unreasonable delays and insurer abuse. The firm must have experience with Independent Medical Examinations (IME) and other insurer-required testing.
Filing a disability insurance claim in a good economy can be frustrating enough. In a recession where the insurer has toughened its practices, it can be overwhelming. But by following these tips and enlisting a qualified attorney, you can secure your benefits.
Ed Comitz and the disability insurance attorneys at Comitz | Beethe protect the disability insurance benefits of physicians and healthcare professionals nationwide. Our Arizona practice focuses on the cities of Phoenix, Scottsdale, Tucson, Flagstaff and Yuma. We provide disability income claim advice, assistance with filing disability claims, including completion of disability claim forms and representation in disability insurance litigation. The information in this article has been prepared for informational purposes only and does not constitute legal advice. Anyone reading this article should not act on any information contained therein without seeking professional counsel from an attorney. The author and publisher shall not be responsible for any damages resulting from any error, inaccuracy or omission contained in this publication.