When you file a long-term disability claim, remember that disability insurance companies are businesses looking to make a profit. These companies often use clever strategies to delay or deny your claim. If your insurance company has denied your claim, you should consider contacting a long-term disability attorney.
We have extensive experience with major disability insurance companies and their sneaky tactics. Since we opened our doors in 2012, we have helped clients across the country recover millions in denied disability benefits. Call us at (888) 321-8131 to schedule a free case review with a disability insurance attorney.
Tricks and Tactics Used To Delay or Deny Your Claim
Disability insurance carriers use the following strategies to avoid paying out benefits. Claimants should be mindful of these tactics as they move through the claim process.
Requesting Additional or Irrelevant Documents
You either already provided these, or they are unnecessary to decide your claim. An example might be requesting your medical records from decades ago, even if that has nothing to do with your current injury or illness. They may try to use these to prove that you had a pre-existing condition to deny your claim.
Changing Your Claims Adjuster
The insurance company may assign a new claims adjuster to your case. The new claims adjuster will want time to review your claim, causing a delay in a decision. Also, when your adjuster is out sick or only works part-time, they may not be available to assist you when needed.
Requiring Multiple Independent Medical Examinations
Another tactic is sending you for multiple independent medical exams (IME). Your insurer can request that you attend an independent medical exam as part of the claims process. The insurance company hires this examiner to put you through rigorous tests to determine if you really are disabled.
The examiner will look for any sign that you are not being truthful and use that to deny your claim. If the IME examiner agrees with your doctor that you are disabled, the insurance company can order another IME. And another. And another. There have been cases of claimants going through 5 or more IMEs before their attorney could stop it.
Twisting Your Job Description
In your application for long-term disability benefits, you must state your job position. This forms the basis for evaluating whether your disability prevents you from performing that job. However, the insurance company will not just take your word for it. The insurance company will request a job description from your human resources department or employer. Your employer will then provide the insurance company with a detailed job description.
This job description is critical to the evaluation of your disability claim because the insurance company is evaluating your medical records to determine whether you can perform the duties of your job. The insurance company may twist your job description to make it appear that you can still work. They may highlight simple daily tasks and make it appear that these are your primary duties and responsibilities.
Because the job description is critical, you must request a copy of the employer-provided job description to ensure it accurately describes your daily work activities. In other words, you may have performed your job differently than described on paper. These differences between your job “as described” and “as performed” may determine whether you win or lose your claim. For these reasons, you must obtain a copy of the job description to ensure it accurately describes your job “as performed” by you.
Video Surveillance
The insurer often uses video surveillance to deny claims. The insurance company will hire an investigator to videotape you outside your home. It is perfectly legal to do this, and they can use the tape in court. They may even talk to your neighbors to learn about your daily activities.
Anything can be taken out of context. They could use a tape of you letting your dog outside to prove you can walk without a cane. It’s outrageous but legal. The best way to protect yourself is to stay vigilant about who is parked outside your home.
Tricky Phone Interviews
The claims adjuster will likely call you and schedule a phone interview to review your claim. During this interview, they will try to make the conversation seem casual. They may try to ask you tricky questions to keep you talking, hoping you will admit to something they can use against you later. Do not be fooled. This is not a conversation with a friend. The claims adjuster’s job is to deny your claim to save the company money.
Wrongful Termination of Benefits
Some claimants may be approved immediately and think, “Well, that wasn’t so bad!” Do not be fooled by fast approval. Many insurance companies require you to submit continuous evidence to prove your disability. This could be evidence that you have kept your doctor’s appointments or verified that you have filled your prescriptions as prescribed. If you do not continue to provide proof of your disability, your benefits may be terminated.
Request a Free Case Evaluation with a Long-Term Disability Attorney
When dealing with the insurance company, remember that they are a for-profit business. They will try to use loopholes and tricky tactics to prolong or deny your claim. You may even get frustrated and tired of waiting and give up, which is even better for them. This is why hiring an experienced professional disability attorney is so important. Let an attorney deal with the tricks and tactics the insurance company uses.
The Ortiz Law Firm is based in Florida but represents claimants anywhere in the United States. We will determine the best strategy to defend your claim and help you navigate the appeals process. If you want to talk to an experienced long-term disability attorney about your case, call (888) 321-8131 or click the button below to schedule a free case review.
