Monthly Claim Handling
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Once an individual is approved for long-term disability benefits, the insurance company has the contractual right to continually evaluate a claimant’s eligibility for disability benefits. In other words, a disability insurance company can deny benefits to a claimant at anytime, regardless of how long the claimant has been receiving benefits.
Once approved for disability benefits, most disability insurance policies require a claimant to submit monthly claim forms in order to prove continued eligibility. Additionally, some carriers will require an Attending Physician Statement on a monthly basis from the claimant’s treating doctor.
Attorneys Dell & Schaefer provide on-going legal representation for individuals that have been approved for long-term disability, in which we are the exclusive point of contact between the disability insurance carrier and our client. The carrier sends all written correspondence and any request for documentation to our office. It is our responsibility to make sure that all claim forms, attending physician statements, medical records, financial documents, or any other documents are provided in a timely manner to the insurance company, so as to protect our client’s disability benefits.
Furthermore, our representation ensures a claimant that they always have a lawyer backing them up and ready to take legal action if the disability insurance company tries to deny benefits. Disability insurance companies will jump on any opportunity to deny a claim, therefore it is important that every document sent to the insurance company is reviewed and scrutinized. A mistake as simple as checking a box saying that you can lift 15 pounds instead of 5, could be reason for the insurance company to deny a claim. The medical records of your own doctor also need to be closely reviewed as there could be detrimental information in your records from a recent office visit.
Disability insurance companies frequently deny claims when a new claims examiner takes over the handling of your claim. For example, we recently received a call from a claimant that Prudential insurance company denied after paying for 18 years. The woman had a brain injury, and Prudential felt that she was better because she could go to the mall and go shopping with her husband.
For most of our clients, we understand that your long-term disability insurance payment is your only source of income. Most clients that hire us for the application process will continue to have us represent them throughout the duration of their claim. Please contact us if you would like more information about our monthly claim handling services.