Over the last several years, disability insurance companies have seen a significant increase in the number of disability claims filed. Concomitantly, there has been a dramatic increase in the number of claim denials, many of which are inappropriate and unwarranted denials. Claims that at one time would have been somewhat perfunctory are now denied.

This increase in denials is likely due to a number of contributing behaviors and causes including:

• Customer’s contractual misunderstandings
• Avaricious insurance industry trends
• Customers’ general lack of knowledge
• Unfair tactics to deny valid claims
• “Bad faith” conduct from your insurance provider
• Veritable breech of contract or insurance fraud

Victims of these causes and behaviors may have the right to take significant legal action against their “bad faith” insurance company. In this blog we hope to increase our clients’ knowledge of the process so that they can make well-informed choices in the wake of a claim denial.

Reasons Given For Claim Denial

When you purchased your disabilities insurance, you did so in good faith that the insurance provider would be there for you when you need them the most. Denial of a claim can be frustrating and disheartening. Here are a couple of the common reasons you may have been given as to why your claim was denied or declared “invalid”:

• Elimination period not being satisfied, either due to the inadequate number of days or days not being consecutive
• Total disability definitions, terms and conditions “were not satisfied”
• Residual disability definitions, terms and conditions “were not satisfied”

Claim Denial Is Not The Final Word

If you or a loved one have experienced a disability that is in accordance with the terms of the disability income policy, your insurance carrier has a legal obligation to pay your claim. A long-term disability insurance denial may be a breach of contract.

One of the tactics that insurance companies use in bad form is to simply delay processing your claim. If your claim for long-term disability benefits has been delayed or denied don’t hesitate to speak with one of The Teal Group’s Santa Rosa disabilities claims attorneys. We can talk with you about the multiplicity of options you have to continue to pursue full compensation from your legitimate claim.

Before a lawsuit is in order, there are several steps we can help you take, including the possibility of filing an “appeal” or “review” of your denied claim. In fact, your current plan may have outlined these options as a buffer before a lawsuit occurs. Let’s discuss the appeal process and help you articulate a well-informed strategy to receive the benefits that may be awarded to you in this claim.

Having an experienced and knowledgeable attorney will greatly increase the chance that your insurance company will rectify their issues. If they don’t, we are poised to represent you in court to force action from your provider to honor their contract. Contact us today!