In the context of long-term disability benefits, qualifying impairments will be defined by your insurance contract. If your condition meets your coverage provider’s definition of disability, it will pay a certain amount of money for a specified amount of time. Once your Barrie long-term disability claim is approved, you will receive a certain amount of money on a monthly basis from an insurance company.
Short- and long-term disability are different types of contracts, the latter being more common than the former. Short-term disability is usually funded by an employer instead of an insurance company and covers the period of time before long-term disability kicks in. Many people do not have short-term disability and must instead rely on employment insurance or something similar.
When an insurance company receives an application for long-term disability, a claims adjuster or manager – who probably does not have very much specialized education – must first determine whether the claimant is insured under a policy. They will also look into whether the applicant purchased the insurance themselves or are on their employer’s policy. For instance, business owners must maintain a list of employees who apply for insurance every month and pay a premium for all of them.
Insurance companies will also evaluate whether an application is proper and contains all three parts from the claimant, their doctor, and their employer. They will then collect any additional medical evidence they may need, including the doctor’s clinical notes and records as well as relevant materials from the employer. After these procedures are complete, an insurance company will come to a decision about whether to approve an application for long-term disability benefits.
It’s impossible to know what argument you need to make if you don’t understand why the insurance company is denying your claim in the first place. You must understand what it is about your application that’s causing coverage providers to deny it before you can put together a compelling argument as to why they should approve your long-term disability claim. If an insurance company is not being forthcoming about why it rejected your claim, enlist the help of one of our elite trial lawyers.
If the insurance company will not give you what you need to move your claim forward, it may be in your best interests to initiate civil litigation. A good disability lawyer can force them to provide something called an affidavit of documents. On the affidavit, they will need to list all the documentation they have relied on in coming to the decision.
Whether you need help confronting your coverage providers or assistance with filing a lawsuit, a lawyer at Rastin Law may be able to help. Our team could force coverage providers to provide disclosure so you can gain a better understanding of the status of your Barrie long-term disability approval.