7 Tips for Maximizing Long-Term Disability Insurance Benefits
Many people purchase long-term disability insurance for peace of mind about the future. The purpose of this type of coverage is to ensure that you have income or funds to pay for living expenses or other needs if you are unable to work due to an injury or illness in the future. However, disability claims aren’t always straightforward and may lead to some stress of their own.
Whether you’re applying for disability or going through disability hearings to learn if your claim will be approved, the process can be long and confusing. Taking some steps to improve the outcome of your long-term disability claim early on in the process—sometimes even before you need to file a claim—can be helpful.
1. Make Sure You Understand Your Policy
It’s critical to understand any long-term disability policy you have. In fact, you should work to understand options even before you commit by comparing disability policies. Factors to consider as you purchase a policy or review any policy you have include:
- How the insurance company defines disability. If you identify known gaps in coverage, you can plan accordingly with additional insurance if necessary. This can improve outcomes if you do experience a disability.
- The coverage period for benefits. Review details about when the coverage period begins and how it terminates, especially if you are purchasing employer-sponsored benefits that might be tied to your job.
- Denial, appeal, and dispute resolution policies for claims. Consider whether there are arbitration clauses and if you have options for bringing disputes to court if needed.
- Whether there are any exclusions that might result in a future claim denial. Some policies have exclusions that won’t cover disabilities that are linked to certain types of activities or illnesses.
Understanding your long-term disability insurance policy helps you avoid surprise denials based on details in the policy you may have overlooked. If you’re not sure about what policy is best for you, consider working with an insurance agent or broker who can provide guidance as you purchase a policy.
2. Advocate for Detailed Records from Your Healthcare Provider
If you are injured or become sick and face a disability, communicate your documentation needs with your healthcare provider proactively. Don’t be hesitant to advocate for detailed records and access to medical files that will let you create a compelling case for your claim. Disability claim denials often relate to a lack of documentation supporting the claim.
3. File Claims in a Timely Manner
Understand the timelines for filing your claim and ensure you file your claim in a timely manner. If there are deadlines of any type, you might be better off filing a claim you know is somewhat weak due to a lack of documentation to ensure you file within the necessary window. You can continue working with medical providers to get additional information that you can use if the insurance company asks for more documentation or your claim is denied and you need to appeal with additional information. However, since appeals processes may vary, consider consulting an attorney for the best course of action, as you may be limited as to what you can add during an appeal.
4. Include Accurate Information and Comprehensive Records
Ensure all of the information on your claim is accurate. Double-check your paperwork or have someone else do it. Something as seemingly insignificant as a typo in your name, Social Security number, or diagnosis code can cause a delay in claims processing or even a denial.
You may be able to include attachments with your claims forms. Consider whether medical records and other information you have would work to your benefit in this context. You may also want to review your policy again as well as any claims instructions to ensure you have addressed all required information.
5. Respond Diligently Throughout the Process
Determine how the insurance company is likely to contact you if it needs additional information regarding your claim. This might be via phone, email, or mail—or a combination of those methods. Keep an eye out for communication from the insurance company and be ready to respond in a timely manner with additional information, clarification, or documentation.
6. Respond to Denials With Appropriate Appeals
Denials are, unfortunately, fairly common with disability claims. While you are the insurance company’s customer, it won’t have a policy of “the customer is always right.” Insurance companies and even government agencies have practical considerations, such as budgets, that factor in.
At the same time, if a claim is legitimately covered by your policy, the insurance company should pay it. That’s why it’s important to review any denials you get and work through the appeals process available to you.
7. Work With an Experienced Disability Attorney
An experienced disability attorney can help you through the entire process of filing and following up on a claim with your long-term disability insurance. If your insurance company is acting in bad faith—such as denying claims that really should be paid under the provisions of the policy or inappropriately delaying the process to avoid paying claims—an attorney can step in to fight for your interests and rights.
If you are dealing with disability claims and don’t believe you are being treated fairly or being paid what you are owed under the provisions of your policy, reach out to a disability insurance claims lawyer. You can contact Roeschke Law, LLC, at 800-975-1866.