Know Why an Insurer May Deny a Long-Term Disability Claim

When you suffer disability, you are entitled to some benefits for the rest of the time you would be disabled. People get disabled through various circumstances such as fatal car accidents, serious slips and fall, and medical practice in a hospital. Disability comes with devastating consequences such as job loss and being out of the business. However, it is surprising to learn that some disability claims could be denied due to several reasons. In case of disability claim denial, the victim should get help from an honest health insurance lawyer New York has to offer. See why a long-term disability claim could be denied:

Lack of disability policy definition

In a disability definition, a long-term policy would either use an ‘any occupation’ or ‘own occupation’. If it’s established that you can’t fulfill the responsibilities and tasks that your specific occupation demands, then you are considered to be under an ‘own occupation’ policy. If you are disabled to a point of not performing requirements and tasks of any occupation, then you are considered to be under the ‘any occupation’ policy. Filing for denied disability claims would be demanding and daunting especially if you don’t have a good health insurance lawyer New York has to offer to help you.

Pre-existing or excluded condition

If a disabled victim has a pre-existing condition or an excluded one, the insurer may decline compensation. Just as any trustworthy disability attorney New York has today would disclose, some long-term disability policies exclude substance abuse-related disorders. If this doesn’t happen, the policy requires the victim to wait for at least 12 months to prove a pre-existing condition. If there is a pre-existing condition you didn’t disclose, the claim you submit may be declined. For more information, visit us at Schwartz Law.

Missing medical records

Having the right medical records is never the main issue in a long-term disability claim. The main issue is who has the medical records. Most insurers expect to find all the pertinent medical records of the individual filing for a long-term disability claim. Two things may arise from this: First, the insurer could have the medical records but regard the medical details provided inadequate and unreliable. Secondly, the insurer could be missing several medical records needed. Whichever the case, you would need the intervention of an experienced long term disability lawyer to sort out the matter with your insurer.

Caught doing what disabled people don’t do

Once a disability claim has been filed, the insurance company conducts a thorough investigation to affirm the disability state of the applicant. It’s known that some people claim to have been disabled, but the activities they engage are questionable. For this reason, an insurance company may use video surveillance to investigate what you do daily. If the investigator finds you doing what you claim you can’t do, you could miss your long-term disability benefits. You would have to hire ERISA lawyers New York has to offer to challenge the allegations of the investigator and have the denied erisa claims paid.

Following a disability claim is one of the daunting tasks you can handle in life. Victims who opt to file disability claims without involving a competent health insurance lawyer New York has today risk a lot. Some of the reasons an insurer may give to deny your claim may not always be genuine. It would take a disability lawyer to prove the insurer wrong based on true facts and reliable evidence. Visit our website at