The insurance company may have the file reviewed by a “peer review” physician, who will likely issue a report questioning any opinions issued by your own treating physicians. Unlike an Independent Medical Examination, this is a paper file review and the reviewer will only have access to the documentation in the claim file, so you will not have to wait for an appointment. However, it does take time for the reviewer to review your file, write his or her report, and submit the report to the insurance company.
Peer-to-Peer Communication
The insurance company may also try to engage in “peer-to-peer” communication between the reviewing physicians and the claimant’s doctors, which is usually a letter to your doctor(s) asking if they agree with the reviewer’s assessment. The insurance company will give a specified time frame to receive a response, and the claim will not move forward until the response is received or the specified timeframe for a response has run out.
While many of our clients hope to receive a decision regarding their appeal as soon as possible, it is important to take the time to dispute damaging information that is produced by the insurance company during the appeal review process. Should your claim proceed to litigation the judge will only review the information that is in the claim file and you will not be allowed to introduce any new evidence.
Legal Representation in Long Term Disability Insurance Claims
Although based in Florida, the Ortiz Law Firm represents claimants across the United States. If your LTD claim has been wrongfully denied, delayed or terminated and you’d like to speak to an experienced Long Term Disability Insurance Attorney contact us at (866) 853-4512 to schedule a consultation. We can help you evaluate your claim to determine if you will be able to access Long Term Disability benefits and how to move forward with the process.
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