Review Your Application For Individual Disability Insurance Before Applying for Benefits

So you’re eager to file your individual disability insurance claim. That’s good. You don’t want to wait too long, because there’s a limited window to file. But stop for just a minute.

Before you do anything else, there’s one crucial step you must take first.

Step One: Review Your Application for Disability Insurance Coverage

We’re not talking about the insurance contract, summary plan description, brochure, or claim form. We’re talking about the original application you filled out when you bought the insurance.

If you purchased an individual policy through an agent, broker, or directly from the insurance company, this applies to you. If you receive long-term or short-term disability coverage as an employer benefit, you likely never completed such an application, so this section may not apply.

Why Reviewing Your Application Matters

Start by calling your agent, broker, or insurance company and request a copy of your application for insurance. Once you have it in hand, review every single answer you provided. Make sure each response is complete and accurate.

If any response is inaccurate, the insurance company may try to rescind your policy by claiming it was based on a fraudulent misstatement. If that happens, the insurer doesn’t have to pay a dime under the policy.

Can They Really Cancel My Policy After Taking My Premiums?

You might be thinking:

“The insurance company can’t cancel my policy after all these years of accepting payments, can they?”

Unfortunately, yes. They can.

This is due to a legal principle known as rescission. Most policies include an incontestability clause, which says that the insurer can’t void the policy after a certain period (usually two or three years) due to a misstatement.

However, under most state laws, an insurer can rescind a policy even after that time if they can prove you made a material misrepresentation with intent to defraud.

A Real Example: Dormer v. Northwestern Mutual Life Insurance Company

In this case, the court found that the claimant’s failure to disclose her history of chronic fatigue syndrome, Bell’s palsy, and back pain to Northwestern was a material and intentional misrepresentation. As a result, the insurer rescinded her policy and denied all disability benefits.

Common Application Mistakes That Can Hurt Your Claim

Problems often arise when the insured didn’t personally fill out the application. For example:

• The agent paraphrased your answers incorrectly.
• The agent misheard or misunderstood your response.
• The application contains partial or missing information.

Even innocent errors like these can give an insurer grounds to challenge or cancel your policy later.

How to Fix Errors Before Filing Your Claim

The good news is that you can correct these issues, but you must do it before submitting your claim. Take time to review your application carefully and fix any inaccuracies before you apply for long-term disability insurance benefits.

RELATED POST: 5 Guidelines To Follow When Applying For LTD Benefits

What to Do If Your Claim Is Denied

Even if you’ve done everything right, your claim may still be denied. Insurance companies often dispute the severity of your limitations, argue that your condition is not covered, or cite technicalities like alleged misstatements on your application.

If you receive a denial letter:

• Read it carefully. The letter will explain why your claim was denied and how long you have to appeal the decision.
• Gather strong medical evidence. Obtain recent office visit notes, test results, specialist evaluations, and residual functional capacity (RFC) forms from your treating providers. These documents can demonstrate how your condition limits your ability to work.
• Do not give up. Most denials can be appealed, and many are successfully overturned with the right evidence and legal help.

Appealing on your own can be difficult. That’s when professional representation can make a real difference.

We Can Help

At Ortiz Law Firm, we represent individuals who have already received a denial of their long-term or individual disability insurance claim. We review denial letters, build strong appeal packages, and, when necessary, file lawsuits to enforce our clients’ rights under the policy.

If your claim has been denied, call (888) 321-8131 or fill out our online form for a free case evaluation. We’ll review your denial and explain how we can help you fight for the benefits you deserve.