Insurance companies often use “boilerplate” language when denying a long term disability claim.
A boilerplate insurance denial refers to a denial of an insurance claim that is based on standard, pre-written language or a generic explanation, rather than a detailed explanation specific to the individual’s claim. This language is often used by insurance companies in an attempt to save time and resources in the claims review process.
Boilerplate denials are often generic and do not provide specific information on why the claim was denied. For example, a boilerplate denial may simply state that the claim does not meet the policy’s requirements, without explaining why the claim was denied or providing any specific information on how the policy requirements were not met.
Boilerplate denials can be frustrating for claimants who are seeking to understand why their claim was denied and what steps they can take to appeal the decision.
More importantly, the boilerplate language may not even apply to the claimant’s individual claim!
Insurance companies issue many different versions of disability insurance policies to different employers. Moreover, a policy with an individual employer may change from year to year. Thus, it is possible that the insurance company quotes policy language that is not even in the claimant’s policy!
If the denial letter purports to quote language from the policy, you should verify that the determination actually relied upon the correct policy language. It may be that the insurance company has quoted language that is not actually in the policy, or there may be a difference in the wording. That could make a major difference to the outcome of your claim.