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How do Disability Insurers Take Advantage of People?

An injury can turn your world on its head. Aside from medical bills and recovery, you may be wondering how to replace your lost income. If you purchased disability insurance, you expect your insurer will provide you with the means to survive, but this isn’t always the case. Unfortunately, insurance companies are notorious for not following the rules. How do disability insurers take advantage of their policyholders? Here are the top ways:

They Write the Policies (and Selectively Omit Terms)

Since insurance companies are the ones that write the policies, they hold all the power. They rely on statistical data compiled by actuaries that break down risk based on medical conditions, age, race, sex, and other factors. In other words, their profit margin is written into your policy already. To make matters worse, they fill their policies with industry jargon and language nonsensical to the average policyholder.

Disability insurers also leave out important terms that delay or prevent payouts. For example, many policies don’t even define what a disability is on some forms. Many companies give their policyholders a form for their physicians to fill out explaining why they are disabled, but these forms don’t even give a working definition of what is considered to be a disability, and that is just one of the many ways insurers give claimants the runaround.

Employers Have Their Own Motives

Often, your disability insurance is part of a benefits package from your employer. Unfortunately, they won’t always help you in with your claim. If the number of employees declaring disability increases, their premiums escalate substantially. This makes for a powerful disincentive for a company to help you declare disability – they may, in fact, undermine your efforts to their benefit and that of the insurance company.

Your Insurer Won’t Help You with Your Claim (or Your Appeal)

Insurance policies are uncanny in their ability to confuse policyholders. If you’re in the position to file a claim for your insurance benefits, you likely have many questions about the process. Insurers may act in bad faith if they refuse to help customers file claims, answer questions in a timely manner, or generally act in a way that keeps the company from approving your claim. In fact, insurance companies encourage adjusters to provide general answers and advice to maximize their chances of getting a claim denial.

Insurers will also issue general claim denials that offer little to no detail on the rejection. They’ll often turn to excuses like “insufficient evidence” to pay a claim. If you receive a list of supplemental items to help them make a claim decision, retain the services of a legal professional immediately. They aren’t asking for these items to help you, but as evidence to use against you.

Further, your insurer won’t help you file an appeal. Insurance companies ultimately want to score a “final denial:” In other words, a denial that you cannot fight in court. They’ll do anything to get this denial, including encouraging you to file an appeal on your own. With enough unsupported evidence appeals, an insurance company can file a final denial, which will leave you with nothing to challenge.

If you’re facing a disability claims process, the best thing you can do is enlist the help of an attorney. From the onset, a legal expert can make sure your needs are accurately represented.

Lawyers know the loopholes and understand the jargon associated with insurance policies. They also have become familiar with the tricks insurance companies use to take advantage of their policyholders. Let one help you get your disability and avoid the disaster of a final disability denial.