A visitor to our website recently posted this great question about the handling of long term disability insurance claims once the definition of disability changes from Own Occupation to Any Occupation.
The change of definition from Own Occupation to Any Occupation is probably the single highest cause for claim denials. An “any occupation” definition of disability is not always the same with every long term disability policy. Some Any Occupation definitions of disability state that the claimant must be unable to perform any gainful occupation and others state the claimant will be disabled from any occupation if he or she cannot perform a job that pays at least 60% of the pre-disability income. The change of definition period, which usually comes at the 18-24 month of an LTD claim is highly scrutinised by most disability companies.
The Level Of Scrutiny Varies With Every Disability Company
After the initial any occupation evaluation is completed the amount of scrutiny that can be expected differs among all of the disability companies. Some continue to manage claims with a high level of scrutiny while others will only request claim forms once every 6 months. The type of disabling condition also plays big factor in the amount of claim scrutiny to expect. “I would like to be able to say that a claimant can rest easy knowing their claim has been approved in the any occupation stage, but it is simply not true.”
We have been contacted by people that have been denied after being paid for 21 years, 15 years, 11 years, 6 years, etc. The claims person on a claim can change the level of scrutiny at anytime. Disability companies often have turnover with disability managers and a new manager brings about new methods for handling claims that have been approved from many years. A claimant can never let their guard down and they must always continue to obtain appropriate medical treatment and maintain outstanding medical documentation of their disabling condition(s).
In order to help claimants avoid claim denials and manage their claims on a monthly basis, we offer an affordable disability monthly claim handling service which you can learn more about by clicking here.