So, you are one of the millions who have been denied your long term disability insurance claim. The question is: are you going to be among the statistics that challenge this decision or among those who accept the outcome?

Insurance companies say,  “we denied your claim but if you want to collect more documents you can appeal.”

This often provides hope. It also means paying doctors for additional notes and copies of records that can be expensive for someone not working. Most often, the claim is denied, again, along with another invitation to appeal. The cycle continues until eventually, the claimant gives up hope.

It is for this reason, that having a lawyer is essential. The insurance company will be given seven days to reassess the case. If not, the lawyer will sue immediately with the goal of securing an income as soon as possible for the claimant.

Predicting what will happen in a courtroom comes down to the documents secured and which expert witnesses are in place with the opinion of the family doctor front and center.

Is there evidence that the doctor supports the claim? While some doctors are sympathetic, the majority tries to assess a situation accurately. Regular visits to the doctor will help, especially if the claimant can provide practical explanations of the difficulties faced day to day.

Is there an attending physician’s statement?

Has the doctor presented a list of all restrictions and limitations of the claimant? This is significantly more helpful than a statement of opinion. An insurance adjuster is indifferent to a doctor’s opinion but will listen more to the list of restrictions.

Truthful, accurate and complete – that is the goal and, always, the winning formula.

If you are looking to appeal an insurance claim, contact Allan Chapnik for a complimentary assessment.

Leave a Reply