Even Northwestern Mutual itself realizes the importance of long term disability: “Don’t let an unexpected injury or illness put your financial future in jeopardy. Disability income insurance from Northwestern Mutual can help you protect your most valuable asset – your ability to earn an income. At the same time, it can also help provide a fundamental layer of security for your financial future.”
That’s why it is even more discouraging and disappointing when Northwestern Mutual denies long term disability claims.
Northwestern Mutual Focuses on Insuring Professionals
Northwestern Mutual prefers to issue long term disability insurance benefits to doctors, lawyers, dentists, and other business professionals.
While insurance companies like Northwestern Mutual have no problem collecting premiums on disability policies, they are not always so eager to pay out benefits on actual claims.
Disability attorney Nick A. Ortiz has experience in handling long term disability appeals with insurance companies. He has an extensive understanding of how insurance companies handle claims. Northwestern seems to be better at paying legitimate long term disability claims than most insurance companies, but even they have been known to improperly deny claims.
Why Would Northwestern Mutual Deny A Long Term Disability Claim?
A Northwestern Mutual disability claim is usually denied when the insurance claims examiner has placed too high a hurdle for the claimant’s ability to prove he or she is disabled.
Every disability policy creates a contract. Thus, the claims process is governed by the language in that contract. Each disability policy includes a proof of loss provision which places the burden of proving a disability on the claimant. To prove a disability, the claimant must submit sufficient medical evidence of his or her disability and proof of his or her job duties and responsibilities.
As part of the disability claims review process, Northwestern Mutual may have its own internal doctors and outside medical consultants review the claimant’s entire file, including all medical records. The insurance company adjuster will look for sufficient proof of a disability in the medical records in order to approve a claim.
The unfortunate reality is that most treating doctors do not take great notes each office visit, and most physicians do not expect their medical notes to be carefully scrutinized by an insurance company. Mr. Ortiz has reviewed all too many claims where the claimant is clearly disabled, but the medical records do not do a very good job of telling the whole story. This benefits the disability insurance company, as the insurance company is only obligated to review the claim based on the medical records available and is not obligated to examine the claimant. If the insurance company does choose to examine the claimant, it is extremely unlikely that the claimant will receive a fair evaluation as the reviewing doctor is being paid by the insurance company.
One of the main things an attorney can help you with during the claims process is the dissection of the report from Northwestern Mutual’s hired doctors and respond with an argument and supporting medical records to explain to Northwestern why the claimant is in fact medically disabled.
Doctors, Lawyers, Dentists, and Other Professionals Must Be Able To Prove Their Pre-Disability Duties and Responsibilities
If you are a physician, lawyer, or other professional applying for Northwestern Mutual Disability benefits, then you must be aware that Northwestern is going to require very detailed information about the work you were performing before you went out on disability. For example, if you are a doctor you will be asked for your monthly and annual CPT production reports for at least one year before your date of disability. You will also be asked to provide a monthly profit and loss statement, recent tax returns, and your daily appointment calendar.
If you are an attorney seeking disability, you may be asked for your appointment calendar for the past two years, your current case list with an itemization of each type of case, a description of your litigation-related work (if you are a litigator), recent tax returns, and monthly profit and loss statements for at least the past two years.
Oddly enough, if you are only seeking Partial disability, then Northwestern’s request for occupational information could be even more extensive.
Most professional claimants will also be asked to be interviewed by a Northwestern Mutual insurance representative. Mr. Ortiz’s suggestion is that such interviews should never take place without legal representation.
Seek Help From an Experienced Northwestern Mutual Disability Insurance Attorney
Mr. Ortiz has seen claims be denied because the insurance company claims there is insufficient medical proof of the claim, or because the insurance company is requesting information that cannot reasonably be produced. Mr. Ortiz takes great pride in assisting claimants in filing appeals in claims that have been wrongfully denied or terminated (where benefits were initially approved but subsequently cut-off). The Ortiz Law Firm also files lawsuits when the claimant has “exhausted” the appeals process with the insurance company.
When your claim for Long Term Disability benefits has been wrongfully denied or wrongfully terminated, it is important to find a lawyer who has extensive experience handling LTD appeals and lawsuits. Nick A. Ortiz is the founder of the Ortiz Law Firm and an experienced disability lawyer. For years Mr. Ortiz has championed for disability claimants and takes great pride in helping disabled persons secure their Long Term Disability insurance benefits.
As a Long Term Disability lawyer, Mr. Ortiz approaches each case with intelligence and experience. He is familiar with the strategies and tactics insurance companies use to deny legitimate claims.
Mr. Ortiz prefers to accept cases immediately after the initial denial letter by insurance companies like Northwestern. He and his staff help prepare and file the claimant’s internal appeal in order to maximize the chances that the LTD claim will be approved or reinstated. Where appropriate, Mr. Ortiz will file a lawsuit against the insurance company with the goal of either obtaining a favorable settlement or prevailing on the merits and having the claimant put back on claim.
The Ortiz Law Firm handles Long Term Disability claims on a Contingency Fee basis, which means that we only charge a percentage of the amount recovered. If there is no recovery, you owe us nothing. If your internal appeal is successful, we charge a percentage of the back pay that is owed and a percentage of your future benefits for 12 months.
The Ortiz Law Firm has assisted numerous doctors, lawyers, and other business owners throughout the nation at all stages of their claims for disability benefits with insurance companies. Contact the Ortiz Law Firm at any stage of your claim at (888) 321-8131 to discuss how we may be able to assist you in recovering disability benefits.