Disability Insurance Claim Denials and How to Avoid Them

When you apply with your disability insurance to receive benefits, there is always the chance they will deny your claim. This could be for various reasons. In this article, we will go over disability insurance claim denials and how to avoid them.

1. You Provided Insufficient Medical Evidence

As part of your application you will have to submit medical proof of your disability. However, if this medical documentation does not clearly show why you cannot work your claim can be denied. To prevent this make sure you are providing detailed medical records and physicians notes. Ensure your doctor describes how your condition impacts your ability to work.

2. There’s a Misunderstanding With Your Policy

Between you and the insurance company there can be misinterpretations of policy language, waiting periods, and/or benefit limits. To help prevent this make sure you are very familiar with your policy. You may also want to consult with an attorney before filing your claim.

3. You Fail to Follow Treatment Recommendations

As part of the process your doctor will ask you to follow a prescribed treatment plan. Failing to follow this plan or missing medical appointments may make your insurance company assume your condition isn’t severe enough to prevent you from working and thus deny your claim. To avoid this happening, follow the treatment plan your doctor recommends. You should also keep records of all appointments, medications and treatments. If you decide not to follow a treatment, document the valid reasons for not doing so.

4. You Provide Late or Incomplete Documentation

Denial of your claim can come from submitting a form late, omitting a signature, or you fail to provide the insurance company with the requested documentation. To avoid this, respond promptly to requests from your insurance company and keep all copies of your submissions.

5. There Are Disagreements About Functional Limitations

Even if you have sufficient supporting evidence your insurance company may still deny your claim, stating that you are capable of working. If this happens take detailed records of daily struggles and how it prevents you from working. Also have your doctor clearly describe your functional limits.

Succeeding With Disability Insurance Claim Denials

With proper planning and assistance there is the possibility that you can succeed in reversing disability insurance claim denials.

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