Don’t give up if your claim for long-term disability (LTD) insurance benefits ends up being denied. Although it might seem like insurance companies deny most claims, there are ways to prove that your particular claim has merit and should be approved. Don’t be discouraged if you are initially denied. With a bit of patience and persistence, you might be able to have your denied claim approved.
Appealing a Denial
You will need to obtain a copy of your LTD policy plan, including the summary plan description. This can usually be obtained from your company's human resources department or directly from the insurer. If the HR department or insurer fails to provide you with the documents you need, you can request them in writing from the plan administrator at the insurance company. Under a federal law known as ERISA, the plan administrator is required to provide you with the documents for your policy.
You will also need to study the letter that explains why your claim was denied. Carefully review the letter and take note of the reasons your claim was rejected. The letter should explain how you can file an appeal and any deadlines you will need to meet.
Once you have studied your denial letter and figured out what aspects of your claim need to be improved, you should begin tracking down missing records. Sometimes, insurers and plan administrators fail to obtain all medical records that are relevant to your claim. Inform your claims representative if anything is missing.
You will also want to include non-medical evidence that can improve your case. This can be written observations from friends and family members about your limitations or testimony from a vocational expert. In addition to non-medical evidence, you will also want to get written opinions about your work-related limitations from your treating physician or specialist. Your treating doctors' opinion is essential when trying to convince an insurance company of your disability.
Are you having difficulty getting approved for long term disability insurance? Contact our team of Atlanta insurance administrators to find out how we can assist you today.