How Can You Appeal A Disability Insurance Claim Denial?

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How Can You Appeal A Disability Insurance Claim Denial?

19 August 2016
 Categories: Law, Blog

When your disability insurance claim is denied, you have the option of filing an appeal. Due to deadlines, it is important that you act quickly to appeal the insurance provider's decision. Here are some tips for appealing the decision.  

Investigate the Denial Reason

Before you can create a strategy for appealing the insurance provider's decision, you need to know exactly why it was denied. Start by re-reading the denial letter. The letter should include a basic explanation of why your case was denied.  

You also need to call the insurance provider and ask for specifics on how the decision was reached. For instance, if the claim was denied because it was not proven that you were impaired and unable to work, find out if the insurance provider received all of your medical records. It might be possible that you can overturn the denial by simply providing more information. 

Review the Policy

Being familiar with your disability insurance policy can help you shape your appeal. If you do not have a copy of the policy, submit a request for one to the human resources department at your employer. In your request, emphasize that time is of the essence. You need to have time to review the policy and complete your appeal within the allotted time.  

Although it might be tedious, take the time to read the policy. You need to understand the wording in the policy that was used to justify the denial. If you are unsure of how the insurance company's reasoning applies to your particular case, ask questions. Contact the insurance provider and ask for an explanation. Keep detailed notes of every interaction you have and if possible, get the provider to send a written explanation, too.  

Gather Evidence to Submit to the Insurance Company

Once you are aware of the reasoning for the denial, you need to gather evidence to counter the argument made by the insurance provider. The more evidence you have, the more likely it is that the insurance provider will respond favorably.  

For instance, if the insurance company was not convinced that you are unable to work, provide written statements from co-workers and a detailed listing of your job duties. Go point by point on the job duties list and state why you are unable to complete each task.  

Appealing a denial of a disability insurance claim can be challenging, but it is possible. Work with an experienced attorney, like one from Iler and Iler, for the best results.