About Disability Insurance Claims

With disability insurance, there are many types of insurance policies available. However, with such a variety of insurance policies, there are more ways that insurance companies can attempt to deny your claim.

Insurance policies typically contain complicated language that the average policyholder may not easily interpret. Often, disability insurance policies contain terms such as “total” and “residual.” A “total disability” entitles the policyholder to the maximum monthly benefit described within the policy. A “residual disability” often means that the policyholder is entitled to a disclosed percentage of the maximum monthly benefit described within the policy.

Beware of insurance disability carriers who try to reduce the duration of your benefits. Some policies provide benefits to a certain age (typically 65) while other insurance policies benefits are for life. Certain disability policies cover expenses such as lost income and business overhead costs. These disability policies are designed to assist business owners.


Filing a Claim & Post-Claim Approval

When filing a claim, there is much to navigate, including claimant statement forms, medical examinations, physician statements, medical records, field interviews, and more. The attorneys at Merlin Law Group understand these type of insurance claims and can assist you in maximizing your claim approval.

Once you receive approval for your disability claim, you are still not finished. Your insurance company will continue to monitor you throughout the disbursement of payments. Whether through periodic medical examinations, the continuing of claimant statement forms or more, the insurance company will continue to evaluate your disability. Even the post-claim approval road can be bumpy. The attorneys at the Merlin Law Group are experienced in navigating the insurance claim process and can work towards maximizing your benefits.


The Importance of an “Own Occupation” Policy

There are different kinds of disability insurance, and it is important to know which one you should purchase. Many different factors go into the decision, but an important differentiation is “own occupation” and “any occupation.”

Own occupation disability insurance is preferred because it will compensate the salary you would receive with your occupation. If you were a surgeon and suddenly lost your hand, you would not want to become a greeter at a grocery store. You would want to be compensated for the salary you would be receiving as a surgeon. “Own occupation” disability coverage would classify you as disabled, because you can no longer perform the job you had. “Any occupation” would not count you as disabled because there are certain jobs you can still perform.

While there are ways Merlin Law Group can help you if you have any occupation disability insurance, it is smart to purchase own occupation if possible.

A second distinction is the lifetime or age of 65 policies. Many disability insurance policies will end at the age of 65. There are other policies that will cover the salary you missed out on because of your disability throughout the rest of your life.


Denial Based on a Lack of Routine Care

A common basis for disability claim denial is a lack of routine care by a physician appropriate for treating the kind of disability you claim. This is a subjective form of denial because many times disabilities can be a chronic problem where it isn’t necessary to visit a physician regularly.

Insurance companies will state in their disability insurance policies what it means to receive routine care, but the definition can be difficult to understand. As a policyholder, you can visit your physician on a regular basis. Also, make sure your physician adequately documents your medical records.


Need More Information?

If your disability insurance claim has been denied, delayed or underpaid, contact Merlin Law Group today for a free consultation.

Submit a Free Case Review