Private Disability Claims Are Often Denied

There is a great disparity in how people think about insurance. Many Florida residents think of it as a necessary evil and purchase the minimum required for specific purposes, while others seek to protect themselves against risk by acquiring upgraded and broader coverage. For example, it is not uncommon for relatively young individuals to buy life insurance, yet, statistically, a disabling injury or illness is far more likely than an early death. However, when it comes to collecting on a filed claim, disability insurers often delay, offer low settlements, or deny the claim altogether.

The first consideration disability experts suggest is to determine one’s anticipated needs. For example, employees may be covered by workers’ compensation, state disability, or employer-paid policies. To the extent some or all of those are available, it also must be calculated what percent of income each replaces. Purchasing a private disability policy makes sense for many who could not maintain their lifestyle on the replacement income.

Purchasing the proper coverage is a necessary first step, but the real test comes when a claim is filed. Unfortunately, many policy holders find their claims denied for one or more reasons. Typical among those are no objective findings of disability, not disabled from the specific occupation, a pre-existing condition, not receiving appropriate medical care, or not fulfilling the elimination period, which requires the individual to be disabled for a certain period of time before filing.

Fortunately, private disability insurers are required by law to provide denied claimants with a detailed explanation for the denial and an established procedure for appeal of the decision. An experienced disability insurance lawyer can offer advice and counsel on the complex regulations and methods governing the insurer’s ruling.