Disability Claims in the Current EconomyJune 4, 2010 | Uncategorized
It can be daunting to make the decision to file a private disability insurance claim in this economy. Insurers now have more incentive than ever to deny payment of “high-end” claims, such as those filed by medical, dental or other professionals. However, there are a few guidelines can help you protect your benefits in these challenging financial times.
1. Understand Why Insurance Companies Feel Pressure to Deny Claims
Disability claims filed by physicians, dentists, and other professionals can be expensive for insurance companies to approve. The troubled economy and the rising number of disability claims filed by professionals have led to financial hardship for the disability insurance industry. This strain on resources creates an incentive for insurers to deny these expensive claims. Thus, many insurers give extra scrutiny to the terms of professionals’ policies in order to find ways to deny benefits, as the financial savings to the insurance company is significant in the long-term.
2. Know Some Basic Policy Terms
An “own-occupation” policy provides benefits following a disability that prevents the insured from performing the particular duties of his or her occupation. If an insured professional does not have an “own-occupation” policy but an “any occupation” policy, in order to receive benefits, he or she must be disabled from performing the duties of any occupation for which he or she is reasonably qualified. Some policies are a hybrid of the two types, providing own-occupation benefits for a limited period of time, then converting coverage to the “any occupation” standard.
Those who are considering filing a claim for disability insurance benefits should meet with an attorney experienced in the area prior to submitting a claim to their insurer. Each disability policy has unique, complex language that insurance companies may manipulate to circumscribe and restrict coverage. Insureds should make a coordinated effort with a lawyer’s assistance to determine whether their particular claim is covered and, if so, how that claim would be best presented to ensure payment.
Look for a law firm that can assist from the beginning of the process through analysis of complex applications and policies and identification of potential coverage issues. The best firms have particular skill in documenting claims, completing claim forms and communicating with treating physicians. Once the claims process begins, a firm should be able to protect clients against unreasonable delays and misconduct by the insurer. You should also seek a firm that provides advice and practical guidance on how best to handle an Independent Medical Examination or other testing that may be requested by an insurance carrier.
Although filing a disability insurance claim in a depressed economy can be overwhelming, the challenges involved are not insurmountable. By following the guidelines above and enlisting the help of a qualified attorney, you can protect your future in any economy.
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.