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How to protect yourself against claim denials

I’ll admit it, I like silly reality shows like “First Time Flippers,” “Bathroom Crashers” and “Worst Cooks in America.” I guess we all take some delight in seeing people fail hilariously before finally getting it right.

Long term disability (LTD) insurers must feel the same way about people who try to navigate the claims process on their own. Sometimes a claimant finally gets it right.  But when they don’t and discover that their insurer has screwed them over, it’s often too late to find an adequate remedy. We don’t find that funny at all. In fact, it’s deplorable. Nevertheless, claimants can protect themselves and reduce the chances they will be taken advantage of. This post will highlight a few ways to do so. 

Keep a written record of all communications – To avoid paying legitimate claims, insurers are likely to play silly games and accuse you of not providing timely information. To avoid this, keep a written record of all communications and information that you send to the insurer.  Same goes for telephone calls:  memorialize important communications in writing so there is no dispute about what was said.

Ask questions – Remember that the insurance company has a duty to investigate your claim and must clearly and thoroughly communicate with you about your claim.  This includes describing the benefits to which you are entitled, information the company may need to approve the claim and explaining the relevant deadlines.  Putting questions in writing will help you get answers and will make a record of your cooperation.

Keep your doctor in the loop – Doctors don’t go through decades of school to deal with insurance company bureaucracy.  However, doctors are a critical part of nearly every insurance claim.  Help your doctors provide relevant information by scheduling appointments when he or she is asked to complete insurance company forms.  Work with the doctor and her medical staff to communicate the nature of the insurance claim and to assist the office with the necessary paperwork.

Insurers don’t always follow the rule when it comes to properly paying benefits. So to get what’s rightfully yours, you may need to take legal action. If you believe your insurer has taken advantage of you, we invite you to call us.  

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