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What to Do if My Disability Insurance Claim Has Been Denied?

Worried disabled woman reading a letter

Every year, millions of Americans apply for benefits from the disability insurance policy they purchased. More than half of these claims are denied by insurance companies. If you have filed for short-term or long-term disability benefits due to an injury or illness and your application was rejected, what are your options? What should you do? Read on for a discussion of how to respond when your long-term or short-term disability claim has been denied, and reach out to a passionate and dedicated Los Angeles disability benefits denial lawyer if you have any legal issues or questions regarding a California disability insurance policy or claim.

Qualifying for disability

You can also purchase a short-term disability insurance (STDI) policy in addition to a long-term disability insurance policy (LTDI) to provide income replacement while you are laid up. Some companies offer these policies as a fringe benefit or allow you to pay premiums with pre-tax dollars. You can also purchase these plans through private insurance. If you are a member of a professional association, the association might offer policies for purchase as a member benefit.
If you purchased an LTDI or STDI policy privately or got it through your employment or a professional association, check the policy language for definitions regarding what constitutes a disabling illness or injury.

Appealing a denial

Disability claims are denied for a variety of reasons. One common basis is fraud: your insurer might believe that you do not have the disability you claim, that you are not pursuing the medical treatments you need, or that you otherwise lied on your application. They may believe that you are choosing to stay home or work part-time voluntarily rather than due to illness. If your claims are denied, you will be given a denial letter which should provide you with the reasons for the denial.

If your claim was denied, you have the right to appeal. If you are claiming short-term or long-term disability under a private or employer-provided plan, you can appeal internally within the insurance company. Review the reasons presented for your denial in the denial letter, collect evidence to support your claim (such as medical records and opinions, observations from your coworkers and supervisors, etc.), and submit an appeal in accordance with the rules provided by the insurance provider. A disability insurance denial attorney can help you gather the appropriate evidence, draft your appeal, and work with you through the appeals process.

Call For Help With a California LTD or STD Disability Insurance Claim

If your disability insurance claim has been unreasonably denied or you are dealing with other bad faith insurance issues in California, fight for the coverage you deserve with the help of the passionate and effective Los Angeles insurance claim denial lawyers at Gianelli & Morris for a free consultation at 213-489-1600.

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