When Accidental Death Isn’t “Accidental”: How Insurers Use Policy Language to Deny AD&D Claims
Accidental Death and Dismemberment (AD&D) insurance promises financial protection after an unexpected tragedy. These policies are marketed as straightforward—if a person dies or suffers a serious injury due to an...
Understanding the Timeline: What Happens After You File a Long-Term Disability Claim?
Filing a long-term disability (LTD) claim is a significant step toward securing the benefits you need to maintain financial stability during a serious medical challenge. But what happens next can...
How to Respond to a Request for Additional Documentation During the LTD Review Process
If you’ve filed a long-term disability (LTD) claim, receiving a request for additional documentation from the insurance company can feel both stressful and confusing. You may wonder what’s missing, whether...
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Our Lee Countydisability insurance attorneys represent policyholders in Florida and throughout the U.S., ensuring everyone has equal access to legal representation that produces real results when they need them most.
Our disability insurance lawyers handle initial disability claims, appeals, lump sum negotiations, and lawsuits on behalf of policyholders nationwide because we know that your expenses do not stop because you have become disabled.
What Type of Disability Insurance Claims Does Disability Insurance Law Group Handle?
At Disability Insurance Law Group, our Fort Myers attorneys represent clients in all 50 states with a sincere focus on pursuing their disability coverage so they can access the benefits they are entitled to, no matter which type of disability insurance they carry.
Our disability insurance claims attorneys in Fort Myers represent policyholders nationwide who have:
Private disability insurance policies.
Group disability benefit plans (typically governed by ERISA).
The similarities in these types of disability coverages make each state’s laws and the claim requirement differences even more confusing when policyholders pursue their benefits.
Understanding your rights and obligations under your particular policy or benefit plan can mean the difference between obtaining the benefits you deserve and a denied claim.
What Types of Disabilities are Covered by Disability Insurance?
Disability insurance covers individuals who cannot work due to various disabilities.
The types of disabilities covered by disability insurance can vary based on the policy and its terms and conditions.
Although not an exhaustive list, common categories of disabilities that may be covered include:
Accidental Injuries
Disability insurance often covers disabilities resulting from accidents, such as fractures, burns, or traumatic injuries.
Illnesses
Many disability insurance policies cover disabilities caused by illnesses or diseases, including chronic conditions like cancer, heart disease, diabetes, or mental health disorders.
Musculoskeletal Conditions
Disabilities resulting from musculoskeletal disorders, such as back injuries, joint problems, or repetitive strain injuries, are typically covered.
Neurological Conditions
Disabilities from neurological disorders, such as stroke, multiple sclerosis, or epilepsy, may be covered.
Mental Health Conditions
Some disability insurance policies include coverage for mental health conditions like depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD).
Pregnancy and Maternity
Specific policies cover disabilities related to pregnancy and childbirth complications, including recovery from a cesarean section.
Infectious Diseases
Disabilities caused by infectious diseases, such as HIV/AIDS or severe cases of influenza, may be covered depending on the policy.
Vision and Hearing Loss
Some policies cover disabilities resulting from significant vision or hearing loss.
Respiratory Conditions
Disabilities due to respiratory conditions like chronic obstructive pulmonary disease (COPD) or asthma may be covered.
Cardiovascular Conditions
Disabilities arising from heart-related conditions, such as heart attacks or coronary artery disease, can be covered.
Autoimmune Disorders
Disability insurance may cover disabilities resulting from autoimmune diseases like rheumatoid arthritis or lupus.
Cognitive Impairments
Policies may include coverage for cognitive impairments, such as dementia or Alzheimer’s disease.
It is crucial to note that the specific types of disabilities covered and the terms of coverage can vary widely from one disability insurance policy to another. Policies often define disabilities regarding their impact on an individual’s ability to perform their occupation. They may also specify waiting periods before benefits are paid and the duration of coverage.
Our skilled disability insurance claims attorneys in Fort Myers will carefully review the policy documents to help you understand what is covered, any exclusions or limitations, and how the benefits are structured. No matter where you live, work, or who your insurer is, we stand ready to help you pursue the disability benefits you deserve. Contact us today to learn more.
Need help with an insurance claim?
Call Disability Insurance Law Group 954-989-9000 — we’re ready to fight for you.
Can My Disability Claim Be Denied Because of My Profession?
Insurance policies can have different definitions of disability, such as “own-occupation” or “any-occupation,” which can impact eligibility for benefits.
The critical difference between the two lies in the criteria used to assess an individual’s eligibility for benefits and the duration of those benefits:
Own-Occupation Definition
Under an own-occupation disability insurance policy, a person is considered disabled if they cannot perform the duties of their specific occupation or profession when the disability occurs, even if they can work in a different field or job.
Benefit Eligibility
With an own-occupation definition, individuals are eligible to receive disability benefits if their disability prevents them from performing their current job duties, even if they can work in another capacity or occupation. This is often the more favorable definition for policyholders, especially those with highly specialized or demanding careers.
Duration
Benefits are typically paid until the individual can return to their own occupation or until the policy’s benefit period expires, whichever comes first. Some policies may convert to an
“any-occupation” definition after a specific period.
Any-Occupation Definition
Under an any-occupation disability insurance policy, a person is considered disabled if they cannot perform the duties of any occupation for which they are reasonably suited by education, training, or experience. In other words, they must be unable to work in any job they are qualified for, not just their current occupation.
Benefit Eligibility
The any-occupation definition sets a higher bar for disability eligibility because it requires individuals to demonstrate that they cannot work in any job they could reasonably perform based on their skills and qualifications. This can make it more challenging to qualify for benefits compared to the own-occupation definition.
Duration
Benefits are typically paid for a specific period, often two years, and may be subject to stricter reviews and restrictions. After this period, the insured may have to meet a higher standard of disability to continue receiving benefits, or the policy may terminate.
The difference between own-occupation and any-occupation can significantly impact the type of protection the policy offers and the likelihood of receiving benefits in the event of a disability.
At Disability Insurance Law Group, we help everyone — no matter their occupation, disabling condition, insurance provider, or where they live in the United States — file their initial claims or fight a dispute or denial so they have the representation they need to obtain the disability benefits they have paid for.
We Also Serve this Practice Area in the Following Cities:-
Contact our skilled disability insurance claims attorneys in Fort Myers today by calling 954-989-9000 or contact us online to schedule a free and confidential case assessment so we can put our over 50 years of combined experience to work for you.
Do You Need Legal Counsel? We Invite You To Contact Us For A Free Consultation.
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