While we certainly do not recommend it, you may choose to handle your own short term disability or long term disability claim.
If you decide to make a disability claim on your own, there are at least three things you should keep in mind when dealing with an insurance company.
1. Insurance Companies are For-Profit businesses.
No matter how nice the claim representative is to you on the phone as you make your claim, she may well have a bias in favor of the idea that your claim may not be legitimate, and to look for ways to deny your claim. Insurance companies make money through premiums. When they actually pay claims, they lose money. Accordingly, they have a strong incentive to deny claims. Do not be lulled into a sense of camaraderie by a friendly claim representative. Do not speak informally or provide information not relevant to your claim as it may be twisted and used against you. Always keep in mind you are NOT talking to a friend, no matter how friendly the insurance representative seems to be. You will almost always do better to handle communications in writing, providing the information requested of you in the claim forms, and providing all other supportive and relevant medical information.
2. Everything you provide to them during your claim goes into your claim file
If your claim is denied and you lose an appeal and have to litigate, everything you have provided, including telephonic communications and written materials, is recorded in the claim file. If you provide information that could be interpreted to support a denial of your claim, you cannot take that back. It will be in your claim file for the life of the claim. The converse is also true and important – anything you would want a judge to see in support of your claim must make it into that claim file with your original claim or appeal; if you fail to provide information during one of these two periods and your appeal is denied, you may very well have no chance to add it later.
3. You cannot rely on an insurance company to obtain document to support your claim.
They will have you sign an authorization to release your medical records. They may even request those records, but never assume they received all of your records or contacted all of your treating physicians. It is extremely important you be certain all relevant and supportive medical records are provided from your treating physicians.
Kantor & Kantor can offer you help with your short term and long term disability claims – from the initiation of the claim, through the appeal level and litigation of your claim, if necessary. We can help you gather the appropriate evidence of disability, and help you in obtaining the support of your treating providers. Most importantly, we can provided peace of mind that your claim is being properly handled.
If you have been diagnosed with a disabling condition, and the symptoms (and side effects of the medications to treat it) become disabling, please do not hesitate to contact Kantor & Kantor for a no-cost consultation at (800) 446-7529.
We understand, and we can help.