How to Respond if Your Long-Term Disability Claim is Denied

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If your claim for long-term disability benefits is denied, you must remember that insurance companies routinely deny legitimate LTD claims because they are a business, and it is in their financial interest to do so.

The first thing to do if your LTD claim is denied is to hire a long term disability lawyer right away. They will go over your options and explain the possible outcomes for each option based on the specific circumstances of your case.

In general, these are your options for responding to a denial of your claim for long-term disability benefits.

Accept the Insurance Company’s Decision

Denial letters are specifically designed to make an insured feel helpless and discouraged. The intention is to intimidate you into believing that you have no case and that even if you do, they are too big, and you will not be able to get them to pay.

If you have a legitimate claim, as many people do whose applications are denied, this is simply not true. Disability lawyers’ level the playing field because they know the law, and they know how to hold insurance companies accountable and make them pay the benefits they owe.

Despite how discouraged you feel after receiving a denial letter, it’s crucial to remember that regardless of the reasons they give, an LTD lawyer knows how to counter their arguments, and you still have hope of receiving your benefits.

Use the Insurance Company’s Appeal Process

Insurance companies have a legal obligation to act in good faith and genuinely consider every application for LTD benefits they receive. Providing a process for clients to appeal denials helps insurance companies argue that they seriously consider every application and reconsider their decisions.

There are very limited instances when an appeal may be beneficial to an insured – like if their condition has significantly worsened since the initial application, they now have compelling medical evidence that wasn’t included in the original claim, or a clerical error was the only reason a claim was denied.

But even if the above circumstances apply to you, you should still seek the advice of an LTD lawyer. For the most part, the appeal process is designed to have the insured run around to get test after test, report after report and ultimately waste time until they deny you a second time.

Despite providing the appearance of a fair decision-making process, appeals are not decided by an independent third party. Appeal decisions are made by the same company that denied your initial legitimate claim, there is nobody to oversee the appeal process to ensure fairness, and ultimately it is still in the insurance company’s best interests not to pay your claim.

Insurance appeals are rarely granted.

Hire a Long-term Disability Lawyer and File a Lawsuit 

One of the reasons for a slow, time-consuming appeal process is to prevent an insured from this very option. You only have two years from the date of your first denial to file a lawsuit and sue for your benefits. Typically, however, this is the only way to get the insurance company to pay a legitimate claim for LTD benefits.

While many people are under the impression that lawsuits take a lot of time to resolve, they generally settle early on in the process, allowing you to claim your benefits and move on with your recovery.