Assistance With Initial Claim Filing

/Original Claim
Original Claim2018-10-09T18:23:54+00:00

The simple act of trying to decide whether to claim disability can be incredibly stressful.  Hard working people often keep pushing to continue even when their health is failing.  As your health deteriorates, your productivity goes down, the quality of your work falters, and you are exhausted at the end of the day from pushing yourself past your limits. You have no energy left for your family or for other pursuits, and you are worried about your health and your family’s financial future.  You know on some level that the situation can’t continue, but you are unsure whether you can really count on your disability insurance to be there when you need it.

Deciding to claim disability is never easy for a professional or executive who has devoted an enormous part of his or her adult life to mastering a skill set and becoming successful at it.  It is an emotional decision, as well as a financial one.

One of the most stressful aspects of the disability decision is not knowing whether your insurance company will accept your claim, or whether it will give you the runaround. They certainly won’t tell you before you stop working that your claim will be accepted. Instead, you have to take the leap of faith of quitting work, applying for benefits, and finding out whether your financial safety net is really in place.

We have helped countless professionals through the process of deciding whether a disability claim is advisable.  And, if it is, we have helped hundreds of professionals make sure that their proof of claim is airtight so the claim is paid as quickly and smoothly as possible. The stress and uncertainty surrounding this unfamiliar process is immediately reduced when you have a disability insurance expert in your corner.

If you find yourself uncertain as to whether to file a claim, or if you intend to file a claim but are uncertain as to how to approach it, please call us for a free phone consultation.

Top 5 mistakes in filing disability claims:

  1. Not realizing you have a partial disability claim.  Many professional disability policies pay benefits if your disability causes a reduction in income as little as 20% year over year.  We have met people who kept working for years, not filing a claim, despite a disability that has cost them tens or even hundreds of thousands of dollars.  Why? Many of these clients bought disability coverage decades ago, and simply forget that the policy covers “partial disability” as well as total disability.  Because insurance policies have timely notice of claim requirements, failure to make the claim can cost tens of thousands of dollars of benefits that otherwise would have been payable – benefits you paid for.  We have succeeded in getting untimely claims “backdated,” but it is better to seek legal advice as soon as a health condition starts interfering with work, rather than waiting, which can be costly.
  2. Assuming the claim forms are all the insurance company needs. Most people give their insurance company only what it asks for during the original claim.  They fill out the claim forms, sign the authorizations, answer questions and then are surprised when the insurance company denies the claim.  Insurance company claim forms tend to focus on orthopedic disabilities and physical work restrictions.  These forms are imperfect, at best, for many subtler forms of disability including cognitive/mental disabilities, disabilities with episodic symptoms, and disabilities causing reduced endurance, to name but a few. A disability insurance attorney can help you be proactive about proving your claim in the most compelling and comprehensive way, in short, telling your story the way it needs to be told. Don’t assume the insurance company will tell you what it needs in order to approve the claim.
  3. Not knowing what your doctors are telling the insurance company. During the initial claim investigation, the insurance company will doubtlessly seek information from your treating physicians, often without including you in the communications. Especially dangerous are unscheduled phone calls between an insurance company doctor and your physician.  Insurance company doctors frequently twist the words of treating physicians to support a denial. Those communications, happening without your knowledge or awareness, often lead to problems causing denial of legitimate claims. Even well-meaning, supportive treating physicians get tripped up in this process and say things that can hurt your claim, perhaps permanently. The disability insurance experts at Robinson Warncke can assist in managing this process to prevent insurance company abuses.
  4. Failing to carefully examine your coverage as soon as your health starts failing. It is critically important from the outset to knowing exactly what your coverage offers and exactly what proof your policy requires.  This is true even if you don’t think you want to file a claim right away.  As soon as your health problems start impacting your work performance you should seek a careful, professional review of your coverage.  Why?  One example: some policies punish you for staying at work too long while sick.  Crazy, but true.  We have seen policies that do not pay any benefits if the insured stays at work more than 365 days after you first receive a diagnosis or experience symptoms from your condition.  On the other hand we have seen policies that exclude coverage where the insured becomes disabled and stops working within the first 365 days of coverage under the policies.  This kind of fine print is never highlighted during the sales process, but it abounds in the world of disability coverage. The reasons are too numerous to list as to why an early review of your coverage can lead to a better outcome for you and your family.
  5. Filling out claim forms without knowing your exact terms of coverage. We have seen occasions when clients and their physicians say things in their claim forms that cause unnecessary problems because of the unique features of their coverage.  A prime example is not fully understanding the policy definition of disability, and answering questions in a way that fall short of meeting your policy’s unique “disability” definition or would subject your claim to a coverage exclusion under the policy.  For instance, claim forms typically ask your attending physician to identify a date when your condition or disability began.  An attending physician uncertain of the correct response and unaware of the meaning or significance of these questions can unwittingly subject your claim to a policy exclusion.   The claim process is perilous even with expert counsel.  Without it, the chance of expensive problems increases drastically.