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's a wise move: you are three times as likely
to be disabled for at least 90 days prior to the
age of 65 than 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 experts
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, 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, and what is required to perform those duties, especially as it may be affected by your disabling condition. For instance, be sure your doctor is advised if your job entails long hours 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 condition. You should then clarify how these restrictions and limitations affect your ability to perform your occupational duties.
Most importantly, you should realize that any claim form you submit to a disability insurance company is likely to be scrutinized with extreme care. Succeeding in any claim depends on not only making sure all appropriate and pertinent information is submitted to the company, but also having every detail perfect. The Law Offices of Mark F. Seltzer & Associates are among the few practices nationwide who handle these kinds of cases every day.
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