Sunday, 14 July 2019

Understanding Long Term Disability Appeal

By Carol Jackson


At times, an insurance company denies the claims of their client. The denial stems from a hundred of reasons, especially if the client did not read what was on the fine prints. Filing a long term disability appeal needs a written letter sent to the company.

Gather knowledge on your insurance policy to aid you in your appeal. Be persistent in learning what you need to learn. You also need to be patient in gathering evidence to counter the reasons and claims of the insurance company. Remember to finish before the appointed deadline for appeal.

Whatever the reason is you must try to understand their reason behind it. Read carefully each section on the denial letter they sent you. If there are some sections you do not understand, call them and ask what that means. You need to be courteous and polite to them because you are seeking vital information to help you.

Highlight some sections that you know and sure are incorrect on their letter. If the reason is you submitted insufficient medical records, then ask them what documents are missing or needs more substantial evidence. Also inquire if they are looking for a particular medical result and lab tests that made them deny your claim. Maybe the medical certificate from your physician was not enough so talk to them why it is so and which part needs more expounding.

Companies would use the reason that your disability would not really affect any of the work that you do. They list the details on the letter they sent you. As a counter, you may tell them the responsibilities you do in the company. Ask human resources personnel to give you a copy of the specifications and description of your job so you can include it in your pile of evidence.

It would be better if you ask for the help of your physician. Ask him specific questions regarding your disability and have it recorded. Have him list the physical and mental limitations you will encounter if you continue to work. Let him also explain the results of your operation and how this will affect your daily routine whether at work, social functions, and home.

Read the section on disabilities in your insurance policy contract and read on what they mean about disability. There are times that your definition is different on their definition. Theirs may either pertain to inability to do any work or to go back to do your own work.

If it matches your situation, then read the copy of your insurance policy. Do cross match between you insurance contract, their denial letter, and with what you have gathered and found out. This may help you in winning the appeal and get that insurance claim.

Lastly, to ensure that they cannot deny you a second time, ask for the assistance of lawyers. They can review your counter claim and affirm it if it is substantial enough for your appeal. With their help, you can avoid any delays and lessens any errors in regards to paperwork. They also know how to craft the letter of appeal so you can persuade the insurance company to retract their decision.




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