Common Tactics Used by Insurance Companies to Deny LTD Claims
Insurance companies use a variety of tactics to deny Long-Term Disability (LTD) claims, including delaying the claims process, misinterpreting policy language, and relying on biased medical evaluations. These strategies can make it challenging for claimants to secure the benefits they deserve. If you are facing challenges with the insurance company, including bad faith insurance tactics, the right legal representation may be able to help you overcome unjust claim delays and denials. Here is more about some of the most common tactics used by insurance companies and what to expect when you file your claim for LTD benefits. A San Diego long term disability lawyer can guide you through the process, ensuring your rights are protected and helping you fight for the benefits you are entitled to. Here is more about some of the most common tactics used by insurance companies and what to expect when you file your claim for LTD benefits.
Common Tactics Used by Insurance Companies
Insurance companies often employ specific strategies to deny or delay LTD claims, prioritizing their financial interests over policyholders’ needs. Recognizing these tactics is critical if you are going to challenge your denial effectively and assert your rights. Some of the most common methods insurers use include:
Delaying the Claims Process
Prolonging the claims process is a common tactic used to frustrate you and discourage you from pursuing benefits. Insurers may request additional documentation multiple times or claim that investigations are ongoing without providing updates. These delays can lead to financial strain for you and your family if you are already dealing with medical bills and lost income. While insurers are required to process claims within a reasonable timeframe, they often exploit loopholes to justify delays. Keeping a record of all communications and deadlines can help hold insurers accountable.
Misinterpreting Policy Language
Insurers frequently misinterpret or deliberately misconstrue key terms in LTD policies to justify denials. For instance, they might redefine the policy’s “disability” clause to claim that you do not meet the criteria. Misinterpretation of terms can leave you without the benefits you are entitled to. Understanding your policy’s specific language is critical to countering these tactics.
Demanding Unnecessary Proof
Insurance companies may request excessive or irrelevant documentation to overwhelm claimants and delay the approval process. This could include requiring repeated submissions of medical records, additional evaluations, or financial documents. Staying organized and maintaining thorough documentation is essential to counter this tactic. Providing complete and accurate records upfront can minimize back-and-forth with the insurer.
Conducting Surveillance
Insurers often use surveillance to monitor your activities and find inconsistencies to dispute your claims. This can include video surveillance, social media monitoring, or hiring private investigators. While this tactic is meant to discredit you, it is often based on selective and misleading interpretations of evidence. You should be cautious about public activities and social media posts that may be misconstrued. Even innocent actions can be misrepresented to suggest that you are not truly disabled.
Relying on Biased Medical Evaluations
Insurers often use Independent Medical Examinations (IMEs) conducted by insurer-friendly doctors to downplay or dismiss the severity of disabilities. These evaluations may be designed to favor the insurer’s position rather than provide an objective assessment. It is not unusual for claimants to face denials based on inaccurate or incomplete medical conclusions. Seeking a second opinion from a trusted healthcare provider can help counter biased IME results. Additionally, providing comprehensive medical records and expert testimony strengthens the claim against unfair evaluations. Our team can challenge biased assessments and ensure the claimant’s condition is accurately represented.
Lowball Settlement Offers
Even when insurers approve claims, they may offer settlements that are significantly lower than the claimant’s actual losses. These offers are often presented as “final” to pressure claimants into accepting inadequate compensation. Many people, feeling overwhelmed, accept these offers without fully understanding their rights. You should carefully review settlement offers and consult with your attorney before you accept. Our firm can assess whether the offer reflects the full value of the claim, including future medical expenses and lost income.
Accusing Claimants of Non-Compliance
Insurers may claim that you failed to comply with the terms of your policy, such as missing deadlines or not providing sufficient documentation. These accusations are often used as a pretext to deny claims outright. In some cases, insurers exaggerate minor issues to justify their decision. Keeping detailed records of all communications, submissions, and deadlines can protect claimants from false accusations of non-compliance. Providing prompt responses and maintaining transparency demonstrates good faith. If an insurer’s denial is based on non-compliance, we can help challenge the validity of their reasoning.
How to Protect Your LTD Claim
Protecting your LTD claim requires proactive steps to counter the common tactics used by insurance companies. Understanding your policy, maintaining thorough documentation, and seeking legal guidance is key to ensuring your rights are upheld. Taking these measures can also reduce the likelihood of a long-term disability denial.
Thoroughly Understand Your Policy
Review your LTD policy in detail to understand coverage specifics, definitions of disability, and any exclusions. Being well-informed about your policy enables you to anticipate potential challenges and respond effectively. Consulting a reputable catastrophic losses attorney can clarify important questions and address any ambiguities that insurers may exploit.
Maintain Comprehensive Medical Records
Consistently document all medical treatments, diagnoses, and communications with healthcare providers. These records are essential for substantiating your disability claim and countering insurer attempts to downplay your condition. Ensure that your healthcare providers are thorough in their documentation and supportive of your claim.
Communicate Effectively with Insurers
Respond promptly to insurer requests and keep records of all communications. Clear and timely responses can prove your cooperation and commitment to the claims process if your case goes to court.
Contact Dawson & Rosenthal, P.C. for Help With Your LTD Claim Today
Filing an LTD claim often comes with challenges, especially when insurance companies employ tactics to delay or deny benefits. Working with an experienced bad faith insurance attorney from Dawson & Rosenthal, P.C. gives you the opportunity to hold advantageous insurers accountable for their actions. We are committed to securing the benefits you are entitled to, so you can focus on your health and recovery. Contact us by phone or through our quick contact form to schedule your 100% free consultation as soon as today.