Today, some people fall under the disability category and might apply for disability benefits Long-Term Disability Claims. With the help of an expert lawyer, you can get all your claims approved. However, there are times when your claims can get terminated or denied.
Some of the reasons are for Long-Term Disability Claims to get terminated:
- Delayed filing
The long-term disability insurance policies usually have “Notice” or “Proof of Claim” clauses that offer a time frame or timeline under which the claimant should file the benefits claim. Hence, if the claimant gets late in filing the same within the estimated time, the claim gets denied based on the clauses.
The insurance organizations integrate such clauses to long-term disability plans because they want to get notified of any claim at the earliest. Here the insurers usually argue that its might be prejudicial for them to get claim after a delay. Based on the extent of the claimant’s delay, certain legal arguments can overturn such decisions of such kind successfully. Your disability lawyer can update you about the same. To know more you can get looking for a disability law firm.
- Not being able to interact with the concerned insurer
Usually, the majority of the claimants think that once they have submitted the initial documentation for the claim to the insurance organization, they need to connect with the concerned insurer. It is essential to know that insurance organizations have an obligation to arbitrate any claim on an end-to-end basis. Hence, if you have got sanctioned of the benefits, an insurance organization will interact with you to get the updated medical records and data. The insurance organization must ensure whether you are opting in for the medical tests for your disability tests mentioned in the policy.
Additionally, the insurance organization might want to talk to you over the phone. And in case they have tried to reach out to you, and they didn’t get any response from you, they might terminate or deny the benefit because they couldn’t connect with you.
- The contractual reasons like exclusion causes for pre-existing conditions
The insurance organization might deny all the disability benefits because of any contractual exclusion. And one of the standard reasons for denying the claim depending on the contractual exclusion gets based on any already existing health condition exclusion cause. This will generally apply to those who claim the disability benefits right within the initial year after the insurance coverage resulted in this effect.
And just in case the insurance organization decides that you took treatment or went to the doctor related to your disability, when the insurance took effect, they can deny the claim. It is considered a technical space and depends on how clause interpretation takes place for long-term disability policy.
At times, claimants have no idea why their disability benefits get terminated or denied. Knowing the reasons mentioned above can always help. Additionally, you can always get in touch with an expert disability lawyer who can help you analyze the reasons better and prepare better for the claim.