Foster Foster

In the days after your illness or injury, you may have held out hope that you could fully recover. Then, it became evident that you may not, and you began to look toward an uncertain future plagued with financial worries. You realized that what you had hoped would be a short-term hiatus from work has now become a long-term issue.

Then you remembered that you decided to participate in your private employer’s long-term disability insurance plan. As you look into filing a claim, it more than likely became clear that the process would not be an easy one. In fact, insurance companies are in business to make a profit, and finding a reason to deny your claim may be a priority for your insurer.

Common reasons for denials

When it comes to denying claims, most insurance companies site the following common reasons:

• You could find work in another industry.
• You fail to meet the insurer’s definition of disabled.
• Your current condition stems from a pre-existing condition.
• You failed to provide verifiable medical evidence to support your disability claim.
• Your disability stems from a nervous or mental condition.
• Your illness or injury occurred while at work, and workers’ compensation insurance should cover it.

If you have not yet filed a claim, keeping these popular reasons for denial in mind could help structure an appropriate claim that could speed the process by avoiding a denial. If you have already received a denial, it could be for one of these reasons, and you may need help in appealing that decision.

Dealing with a denial

If you received a denial of your claim, you have a limited time to appeal. You must follow strict federal guidelines regarding filing an appeal since you obtained your policy through your employment. Without assistance, it would be easy to miss an important step, document or deadline. Following the established guidelines to the letter may also preserve your right to file a lawsuit to receive benefits if necessary.

Often, the courts may only look to your claim file for the evidence it needs to make a decision regarding your claim. Therefore, your appeal would be the perfect opportunity to ensure that all pertinent information gets into your file. You could include information from your doctors, employer, psychologists and any other experts that can provide verification of your disability to the insurer (and the courts if you end up needing to file a lawsuit).

Dealing with a lawsuit

If the insurance company denied your appeal and you followed all of the applicable rules regarding that administrative process, your next step may be to file a lawsuit. This legal process involves its own documentation requirements and deadlines. Again, you may benefit from obtaining help to ensure that you provide the right information and meet all deadlines.

Improving your chances of receiving benefits

As you can see, there is much more involved to receive long-term disability benefits than just filing a claim form. Considering the fact that your financial future may be on the line, it would greatly benefit you to consider seeking out the appropriate guidance and advice from a South Carolina attorney who is well-versed in these matters.