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February 2012 Archives

Preparing for a Possible Disability Claim

Our Firm often receives inquiries from individuals who are currently working, but due to the nature of their particular illness or injury the possibility of filing a disability claim at some point in the future appears inevitable. They are relying on their disability policy to provide them with the financial support they will need once they can no longer work. It is therefore, extremely important that they maintain coverage under that policy and qualify for the highest benefit possible if and when they must file their claim for benefits.

Your Disability Insurance Claim Can Be Denied Or Terminated Based Solely Upon The Opinion Of An Unscrupulous Physician Hired By Your Insurance Company

Your disability insurance claim can be denied or terminated based solely upon the opinion of an unscrupulous physician hired by your insurance company. Typically, these so called "paper reviewers" make a substantial amount of money working for insurance companies. At DI Law Group, we receive numerous calls from claimants that attempted to apply for benefits on their own or were receiving benefits and were shocked to find out that their insurance company suddenly, and without warning, decided they are no longer disabled and terminated their monthly check based upon the opinion of a physician who never examined them, talked to them, or even bothered to contact their treating physician. With a physician certifying that the claimant is not disabled, it can be very difficult to overcome. Often it requires filing an aggressive and comprehensive appeal with statements from our client's physicians and obtaining our own independent medical review or independent medical examination to overturn these unreasonable denials.

Can signing a severance agreement with your employer affect your disability benefit claim?

Signing a severance agreement with your employer can hugely affect your disability benefits claim.  In fact, by signing a severance agreement you can entirely waive your right to pursue your disability benefits claim. Most severance agreements drafted by your employer's lawyers include broad reaching language that requires that you agree to release your employer from any and all claims that you may have against your employer in exchange for, and in "consideration" of, the amount of money to be paid you under the severance agreement. The wording of severance agreements vary greatly, but no matter how broad or specific the language is within the severance agreement presented to you by your employer, the danger exists that in signing the severance agreement you are waiving your rights to your disability benefits claim under a group disability benefit plan provided to you by your employer as a benefit of your employment.

DELAYED CLAIM APPROVED AFTER DI LAW GROUP ATTENDS FIELD INTERVIEW

As noted in some of our previous blogs, insurance companies often require an in-person or telephone interview with a claimant either prior to making a claim determination or during the ongoing evaluation of a claim that is being paid. The goal of the insurer's interview is not simply to better understand their insured's claim, but to acquire information that can be misconstrued or taken out of context -and ultimately used to further delay or deny the payment of benefits. In many cases, the insurance company has provided the interviewer with specific information it considers problematic and has instructed the interviewer to delve into these issues. Most of the time the red flag issues are not openly acknowledged, but rather addressed in an indirect manner. Thus, rather than providing the insured with the opportunity to directly explain any alleged problems or inconsistencies, the interviewer asks indirect questions hoping to elicit information that can be used to deny benefits. Examples of red flag issues include information from a tax return, information obtained by looking at corporate filings, pictures or comments posted on an insured's social network page, surveillance video footage, and information (or the lack of information) within a set of medical records.

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