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.

What reason they come up with may be, understanding it should be a priority before you can build a substantial case. Their denial letter and each section on it should be read thoroughly. Call them and inquire as to what each of them mean. Remember, you are doing this so you will have important information. It would be prudent if you are polite in conversing with them.

If there are parts that you know yourself are incorrect, highlight them for further evidence. When their reason for denying it is because the medical records you submitted are insufficient, ask what other documents do they substantially need. Also add if there are specific lab tests and medical results they particularly need in your records. It might be that what your physician wrote on the medical certificate was not enough for them. Inquire as to why that is so your physician, and even you, can expound it to them.

Most companies would reason out that they did not find your disability to affect your work. If this is the reason detailed on their letter, let them know the duties and responsibilities you have in the company. Include a copy of your official job description and specification you got from the human resources department. This is so they know that your reason is valid and should not have been denied in the first place.

Your physician can help you in gathering further evidence. As a medical practitioner, he knows how this disability can affect your physical and mental capabilities. Always ask specific and particular question in regards to your condition. Have him explain how this can affect your routine every day at social functions, home, and work. Record and list it all.

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.

Ask for a lawyer to help you so that the company would not have any reason to deny your claim again. Reviewing your counter claim and affirming it for substantial evidence is how they can help you. You part is to attach all evidence documents you filed up to the appeal letter. Due to this, delays are avoided and errors are reduced in your paperwork. They also have ways in crafting the appeal letter to persuade the company in retracting the decision.




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