If you've been a Victim of Fire or Water Damage
The proverbial peace of mind holding a disability income policy can bring may be abruptly shattered if you find it necessary to file a claim. All too often, claimants find themselves caught up in a tangled maze of paperwork thrust upon them from their insurer, which seems designed to confuse the issue and delay or deny coverage, rather than honor a legitimate claim. Learn how to ensure your rights are protected.
Insurance Company Tactics
Although some critics will tell you insurance companies are in the business of denying claims, the reality is they generate income from selling policies and incur expenses when they pay claims. Some companies are worse than others, but most use some or all of these tactics in one form or other to delay and deny your claim:
• Lack of transparency in selling the policy: An insurance policy can be complex, but the included coverage is often sold in vague or downright deceptive terms.
• Playing games with your claim: An inordinate number of legitimate claimants, for example, report they were sent the wrong claim forms by their insurer when they inquired as to the procedure for initiating a claim. Another favorite tactic is blaming you, the claimant, for not providing sufficient information to begin the process.
• Relying on language not in your policy: It is not unusual for an insurer to make a specific denial based on policy terms, yet that precise language is nowhere to be found in your policy.
• Rigging the game: Most policies are written to allow an independent medical examination to provide objective evidence of your condition. Unfortunately, many of those examiners are biased in favor of the insurer and sometimes even incentivized to render a finding against you.
Ways to Help Yourself
You can be your own advocate, either proactively before something happens, or in response to a denial by doing the following:
• Know what your policy says. Yes, this means you’re going to have to read your policy, but it’s the only way to really know what it covers, and especially what it excludes. Many insurers make it a point to not provide a copy, so it may be necessary to demand one.
• Understand what your policy says. This is not as easy as it may sound. For instance, the definitions section will define words used in the policy that may be contrary to what you believe to be their plain English meaning. Seek help if you do not understand the wording.
• Don’t automatically accept a denial. Although they may not tell you unless you ask, your insurer must provide a way for you to appeal their decision. Be very careful here. Insurers routinely try and limit whatever information is to be considered in this preliminary administrative review because if your case ultimately reaches the lawsuit stage, the evidence may be confined to what was considered in the first appeal.
Contact a Long Term Disability Insurance Lawyer for Legal Advice
Insurance is a big business that generates profits through the denial of legitimate claims. Protect your rights.