Five Common Excuses used by Insurance Companies to Deny your Disability Claim

If you have received a letter from an insurance company denying or terminating your long term disability benefits, you might feel discouraged by some of the reasons used by the company to turn you down. However, we urge you not to give up and understand that insurance companies often deny long term disability without sufficient basis. At RamosLaw, we know very well that disability claims examiners at insurance companies use the same baseless excuses to deny claims over and over again. If your long term disability benefits have been denied or stopped, we ask that you contact us for a free evaluation. We will evaluate whether we can help get your long term benefits approved or reinstated.

Here are Five of the most common excuses used by long term disability companies to deny your claim, as well as some of the reasons why they might be flawed:

1. There is no objective evidence of disability. Many denials assert that the long term disability claim was denied because there was no objective evidence presented. However, it is well established that objective evidence is not always possible to support a claim. In fact courts have recognized that it is unreasonable to require claimants to provide objective evidence of ailments such as fatigue, pain or mental illness.
2. The definition of disability has changed. Most long term disability insurance policies provide that benefits are paid for a period of time (usually 24 months) if a person is unable to do his or her own occupation. After this initial period is over, the insurance company only provides coverage if the person is unable to perform any other work. We find that the change in definition just serves as a perfect opportunity for the insurance company to stop benefits. In many instances, the person is still completely disabled and the company just does not want to acknowledge it.
3. Surveillance video shows that you are not disabled. We see cases involving surveillance videos over and again. In most cases surveillance video can be explained away. Moreover, these videos present a single moment in a person’s life and are not representative of whether a person is really able to work or not.
4. The Insurance Company’s doctor state that you are not disabled. The insurance companies contract “hired guns” to issue medical opinions in long term disability cases. We research your case thoroughly and are often able to prove that the opinion of the insurance company doctor is biased due to their economic interest in receiving business from the insurer. We try to work with your own doctors to prove your case. We maintain that the best person to issue an opinion in your case is your own doctor, not someone who knows you simply from a paper review of your file or from a brief evaluation that only lasts a few minutes. By carefully studying your claim file, we are able to point out inconsistencies or omissions in the report prepared by the doctor hired by the insurance company.
5. The Social Security Disability decision does not apply to your case. The insurance companies constantly disregard the Social Security’s determination in their denial letters. In many instances, courts have found that this practice is illegal. Insurance companies must carefully consider Social Security’s determinations. Moreover, in many instances the standards used by Social Security to determine disability are a lot stricter than the standards required under long term disability policies. We have been able to reverse many long term disability denials based on the fact that the insurance company failed to give proper weight to the Social Security decision.

Empowering you to fight for your rights

We are here to help you and empower you with valuable information regarding long term disability benefits. At RamosLaw, we handle calls from hundreds of affected parties like you, who may not have a clear idea of what to do and how to go about appealing a denial of benefits. There is no cost involved in the initial evaluation. We assure you that we will give you an objective picture of how strong your claim is and whether you should retain us to act as your lawyers.

For a free evaluation with a Connecticut or Massachusetts Long Term Disability Lawyer, you can contact us or call toll free (860) 519-5242.

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