When a person becomes disabled and is unable to work, long-term disability (LTD) benefits can be a crucial source of financial support. However, even if a person has paid for LTD insurance, their claim for benefits may be denied. Here are some reasons why an LTD claim may be denied and what to do if it happens.
Failure to Meet the Policy Requirements
One of the most common reasons an LTD claim may be denied is because the person does not meet the policy requirements. LTD policies have specific guidelines for what constitutes a disability and how long a person must be unable to work before they are eligible for benefits. If the person's disability does not meet these guidelines, their claim may be denied.
Lack of Sufficient Medical Evidence
When applying for LTD benefits, it is important to provide medical evidence that supports the claim. This includes detailed information about the disability, how it affects the person's ability to work, and the treatments that have been tried. If there is not enough medical evidence to support the claim, the insurer may deny it.
Disputes Over the Cause of the Disability
In some cases, the insurer may dispute the cause of the disability. For example, they may argue that the disability is a result of a pre-existing condition, rather than an injury or illness that occurred after the policy was taken out. If there is a dispute over the cause of the disability, the insurer may deny the claim.
Failure to Meet Deadlines
When filing an LTD claim, there are strict deadlines that must be met. For example, the person must file their claim within a certain period of time after becoming disabled. If these deadlines are not met, the insurer may deny the claim.
What to Do if Your LTD Claim is Denied
If your LTD claim is denied, it is important to understand your options. The first step is to review the denial letter and understand the reasons why the claim was denied. It may be possible to appeal the decision or to provide additional evidence to support the claim.
In some cases, it may be necessary to take legal action. A lawyer who specializes in LTD claims can help you understand your rights and options, and can represent you in any legal proceedings. Hiring a lawyer who specializes in LTD claims can be extremely beneficial. Here are some ways that a lawyer can help you if your LTD claim is denied:
Reviewing the Denial Letter
A lawyer can review the denial letter from the insurance company and help you understand the reasons for the denial. They can also explain your legal rights and options for appealing the decision.
Filing an Appeal
A lawyer can help you prepare and file an appeal of the insurance company's decision. This may involve gathering additional medical evidence, reviewing the policy language, and arguing your case in front of an appeals board.
Representing You in Litigation
If your appeal is denied, a lawyer can represent you in litigation against the insurance company. This may involve filing a lawsuit and presenting evidence in court to support your claim for LTD benefits.
Negotiating a Settlement
In some cases, a lawyer can negotiate a settlement with the insurance company that provides you with the benefits you are entitled to. This can often be a faster and more cost-effective solution than going to court.
A lawyer can provide you with legal advice and support throughout the entire process of appealing a denied LTD claim. They can answer your questions, help you understand your legal rights, and provide guidance on the best course of action to take.
If your LTD claim has been denied, contact us for a Free Consultation. There is no obligation, so you can meet with an experienced disability denial lawyer that has recovered millions of dollars on behalf of injury victims just like you. To get started, call us anytime, our phone lines are open 24 hours 7 days per week, or complete our online contact form here.
Andrew Iacobelli is an experienced personal injury lawyer who established Iacobelli Law Firm with offices located in Ontario, Canada and Florida, U.S.A. Andrew restricts his practice to the representation of personal injury victims in claims involving serious injuries, Catastrophic Injuries, and wrongful death in Canada and the United States. Andrew is a lifetime member of the Million Dollar Advocates Forum, and the author of "Are You a Canadian Injured in the United States? Claim the Damages and Insurance Coverage the Right Way". Andrew also hosts a popular podcast and YouTube channel on the subject of personal injury law and the rights of injury victims.
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