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Home > Denied Disability Claims for Doctors



Unlike many other professions, even a minor injury or illness can cause a doctor to be unable to perform their duties either temporarily or permanently.  A surgeon who breaks a finger on their dominant hand is unable to perform surgeries.  If they lose that finger permanently, or if they suffer from carpal tunnel syndrome or another permanent malady, they might lose the ability to perform surgeries forever.  Likewise, a doctor who contracts an infectious disease is likely unable to treat any patients or even enter a hospital for fear of spreading the disease to vulnerable patients.

Because their practice can be so fragile, disability insurance providers make exorbitant amounts of money selling disability insurance policies to medical doctors and other medical professionals such as nurses, chiropractors, dentists, and physical therapists.  One would think that filing a claim for disability insurance coverage would be a straightforward and painless process.  Unfortunately, insurers have no more loyalty to doctors than they do to any other policyholders, and they are always on the lookout for any reason, real or fabricated, to deny or underpay a claim.

Disputing Common Reasons for Denial of Disability Benefits

Insurance providers look for any reason to deny or limit payments on a claim.  They are especially wary of long-term disability claims from medical professionals, given the high salaries and benefits a healthy doctor would otherwise enjoy.  Here are some of the tactics that disability insurance providers might employ to refuse or limit coverage for medical professionals:

  • The insurance provider could claim that the doctor is still able to do “portions” of their specialty. Some policies specifically cover a doctor’s ability to do their specialty, such as heart surgery.  Even when a heart surgeon is no longer able to perform surgery, however, the insurer may turn around and claim that the doctor can still perform “some” functions.  We know how to keep insurance providers from taking unsupported views of the language in their policies, and we know how to hold them to task when they persist with a wrongheaded interpretation of your coverage.

  • The insurer might claim the doctor is only partially disabled and can still perform other medical functions, such that full disability payments are not warranted. They may try to limit the length of the benefits owed, or fight a claim of total disability until after the doctor reaches a certain age in order to avoid paying full benefits.

  • The insurer may point to a technical error, such as a failure to file a claim within certain time periods. Many medical professionals try to diligently work through an illness or injury at first, hoping for a quick recovery.  Unfortunately, insurance providers may try to use that diligence against the doctor, denying claims because the doctor tried to keep helping patients.

  • Issuing onerous document requests and continually claiming that the policyholder has not satisfied the requirements. This is a common stalling tactic used by insurance providers to browbeat policyholders into dropping a claim or accepting a lowball settlement.  We will not let your insurer bully you into accepting less than your claim is worth by delaying your coverage with a bogus investigation.  We will make sure that your provider knows that they must conduct a proper investigation, and do so timely, rather than try to stall you out.

At Gianelli & Morris, we know the games that insurance providers play, and we know how to go toe-to-toe with them to make the games stop.  If they engage in bad-faith tactics or wrongfully deny your claim, we will fight to make sure that they are held accountable for the benefits they owe and the harm they have caused you.

Fight For Your Right to Disability Insurance Coverage With a Vigorous Legal Warrior On Your Side

Arguing against a disability insurance company that wrongfully denied your claim for coverage requires a seasoned, passionate, and talented legal team.  You will be up against a large corporation with significant legal resources.  If you are taking on a disability insurance provider, you need a law firm in your corner that knows the law and knows how to fight.  You can depend on the California disability insurance attorneys at Gianelli & Morris.  Our disability insurance denial legal team understands that your livelihood and your financial security are on the line, and we will do everything in our power to ensure that you get the coverage you are owed.

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