As a professional with significant responsibilities and obligations, you cannot afford to give up your future income under any circumstances—which is why you almost certainly carry significant individual or long-term disability protection. It is a wise move: you are three times as likely to be disabled for at least 90 days prior to the age of 65, as you are to die before that same age.
A New Environment
Sadly, the protection you count on from your disability policy may not be as reliable as it once was. In recent years, disability insurance companies have become extremely aggressive about denying liability and minimizing payouts. These companies literally have forensically trained teams of consultants reviewing every word of every document you submit in search of ways to defeat your claim. They can be calculating and systematic, especially in considering high-dollar-value claims like yours. Favorite strategies for non-payment include a host of legal issues such as: the incontestability clause, pre-existing conditions, legal and social disability defenses, the “risk of relapse” defense, choice or lifestyle change issues, lack of severity, not receiving appropriate medical care, not satisfying contract definitions of total or residual disability, or an argument that the insured is residually disabled instead of totally disabled. Another tactic is to demand more and more non-pertinent information—to dissuade the processing of claims.
A Sensible Approach
However, there are things that you can do to protect yourself. One basic precaution is to choose a doctor who will give your claim maximum credibility, specifically one who is well credentialed, forensically trained, and specializes in your exact disabling condition. When you see your doctor, be sure to give him/her an education on your specific occupational and professional duties, what is required of you to perform those duties, and how those duties may be impacted by your disabling condition. For instance, be sure to advise your doctor if your job entails the performance of multi-tasking, decision-making, and functioning at an executive level, so he or she can make a full and accurate assessment of your ability to work.
Other crucial steps include understanding your own contractual obligations under your policy and identifying issues that might derail your claim. It is also essential to establish the duties and responsibilities of your “own occupation” and then to clearly determine, with your treating physicians, any and all restrictions and limitations you face as a result of your medical condition. You should then clarify how these restrictions and limitations affect your ability to perform your occupational duties.
Most importantly, you should realize that a disability insurance company will scrutinize all claim information you submit with extreme care. Succeeding in your claim depends on not only making sure all appropriate and pertinent information is submitted to the company, but also having every detail perfect. Seltzer & Associates is among the few practices nationwide who handle these kinds of cases every day.