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Four Reasons That Lead to Denied Disability Insurance Claims and How to Avoid Them

8 July 2021

Celina Henry

Every year, millions of people apply for disability insurance claims. Unfortunately, out of the millions that apply, only a fraction of the applicants get their disability settlements while the rest are denied. There are numerous reasons why your disability insurance claim can get rejected. However, most of these reasons are avoidable if you put in the necessary due diligence in the application process by utilizing a disability lawyer when dealing with the insurance company.

With that in mind, here are four reasons you could get a denied disability insurance claim and how to avoid them.

Lack of Sufficient Medical Evidence

Irrespective of whether you are claiming short-term or long-term disability, it is essential to provide enough medical evidence to prove that you are not in a position to work due to your condition or injuries. Insurance claim adjusters make a point of evaluating and scrutinizing every type of claim they receive. Thus, if they are not adequately convinced by the medical evidence you provide, they will automatically deny your disability claim.

It is advisable to seek out the services of a disability lawyer so that they can collect enough medical evidence to prove that you are eligible for disability benefits. A disability lawyer is well versed in filing disability claims. They know how to gather and present medical evidence in a manner that will ensure you don't get a denied disability insurance claim.

You Have Been Denied Before

A common mistake people make when they get a denied disability insurance claim is to apply again instead of appealing. Remember, insurance companies keep records of all the disability insurance claims they receive, including the denied ones. Therefore, when you apply once again after being rejected the first time, it raises a red flag in their system, and the insurance company will likely deny your claim for the second time.

It is advisable to appeal your disability insurance claim when it gets denied instead of applying again. When it comes to appealing a denied disability insurance claim, it is always advisable to enlist the services of a disability lawyer. They will strive to discover why the claim was rejected in the first place. When the time comes to appeal the disability claim, the lawyer will be in a position to negotiate or argue your case from a better perspective.

Late Filling

Insurance companies have a stipulated proof of claim clause in their disability insurance policies. The proof of claim clause specifies a given period within which a person should have filled their disability claim with an insurance company. If you file your disability claim after the stipulated period has passed, your disability claim will automatically be denied.

Therefore, if you are planning to file a disability insurance claim, it is advisable to do so via a disability lawyer. A disability lawyer is fully aware of such clauses and will quickly file your disability claim before the given period expires.

Pre-Existing Exclusion Clause

If you are filing a disability claim under a group disability insurance, chances are there is an exclusion clause in the policy for long-term disability benefits. An exclusion clause typically states that the insurance company will compensate you for short-term disability but not for long-term disability. Therefore, you will receive benefits for the short-term, but afterward, the insurance company will cease to provide payments for your disability. If you file a claim at this point for long-term disability insurance, you will automatically get denied because of the exclusion clause in the policy.

However, instead of giving up, it is best to get in touch with a disability lawyer to help you find a way around the exclusion clause. With a seasoned disability lawyer, it is relatively easy to work around the issue and get your long-term disability benefits.

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