Long-term disability claims are complicated. If you are dealing with a claim yourself, this probably comes as no surprise. Disability claims are denied all the time, most often for either of these two reasons:
- The claimant does not meet the conditions for being disabled as defined in his/her contract, but usually and more likely…
- The claimant is a victim of a Frivolous Denial of their claim.
Unfortunately, there is little that can be done for claimants who don’t meet their contracts’ definitions of disabled. However, frivolous denials, which are far more common reasons for denial, are unethical and can be argued against.
Why Do Insurance Companies (Actually) Deny Your Claim?
The insurance company has a financial incentive to deny you. When they deny your claim, they are saving money. Moreover, they’re not fulfilling the financial responsibility they made with you, the client. But why would insurance companies deny you if you have a completely reasonable claim? Here’s why:
- They are counting on you to simply walk away.
- The insurance company is counting on frustrating you, not only by denying you but by repeatedly denying you. If you walk away out of frustration, the insurance company has essentially bullied you out of your money.
- They are counting on you to appeal on your own.
Taking on the insurance company on your own is brave but is often a costly a mistake. They have been in the business for a long time and have their own attorneys who make their livings on denying insurance claims. The insurance company will nearly always win when you appeal your claim on your own – they simply have the resources and experience to outmaneuver and overpower most claimants.