Jan 30, 2026 - Disability Insurance by Seltzer & Associates
It’s supposed to be good for the environment. It’s supposed to be less expensive. It’s supposed to make life easier and information more accessible.
The first two statements may be true, but the switch to digital “portals” for sharing information is not making life easier for many disability insurance policyholders who need to file a claim. While there are some advantages to handling material digitally, there is a significant potential for critical information to get lost in cyberspace. When you add the fact that disability insurance companies are increasingly relying on AI to evaluate claims, the potential for mislaid and misinterpreted information grows exponentially larger.
Storing files digitally and delegating tasks to AI are undoubtedly saving insurance companies money. But it is important for policyholders to understand how to protect their rights and ensure that vital information gets reviewed and properly evaluated. At Seltzer & Associates, we know that problems often lead to unwarranted claim denials and to benefits being wrongfully discontinued.
Why it Matters
The promotional materials may make the process look easy. But if you file a claim for disability benefits under an insurance policy and you do not include all the evidence and information expected by the insurance company—in the format required by the insurance company—then the company will use that as an excuse to deny your claim. Before denying your claim, they may delay acting on your claim for a considerable period of time.
Both delays and denials can result from lost or misclassified information. When you need disability benefits to make up for income lost because a disability prevents you from working, the delays can be highly problematic. A denial compounds the problems and adds insult to injury.
Sometimes, claims are denied because a policyholder does not meet the policy’s standards. But in far too many cases, a claimant is clearly eligible for benefits under the terms of their policy, but the insurance company does not approve the claim. This has been happening for decades, of course, which is why our firm decided to focus on fighting for the rights of disabled professionals who have been wrongfully denied benefits under their policies. But the new digital portals and use of AI have increased the potential for unjustified denials.
Filing a Claim
The problems often begin when a claim is initially filed. While it is vitally important to comply with filing deadlines, it is equally important to comply with filing protocols. We often assist policyholders with the process of filing an application for benefits to prevent problems before they occur.
A key component of success when filing a claim for short– or long-term disability insurance is understanding what the insurance company is asking for. Sometimes insurance providers seem deliberately vague in this regard. They might ask a claimant to “describe” or “explain” something or make a “statement” and provide very little space to answer, thus giving the impression that they only need a simple and concise answer.
In reality, however, they often need to see an explanation that satisfies several critical requirements. Insurance companies may be using AI to evaluate answers, and if it does not recognize the words that meet those critical requirements, the program will automatically reject the claim. The use of AI in the claims evaluation process can also cause difficulties when a medical specialist uses terms that the program misinterprets.
If you don’t know the requirements the insurance company evaluators are expecting to see or you don’t know the specific language the program is looking for, your claim could be denied repeatedly. Each time, you might be getting closer to an acceptable application, or you might be continuing to stumble around in the dark, making no progress. Unfortunately, insurance companies frequently do not openly reveal what they are actually seeking.
When you work with an experienced disability insurance lawyer, however, your legal advisor should know the requirements the company needs to see fulfilled and the terms and evidence needed to satisfy the requirements. For that reason, working with an attorney from the start of the claims process can potentially save you considerable time and frustration.
Ascertaining Deficiencies When Information Gets Lost
Sometimes claims are delayed or denied because the desired information was not submitted. But other times, problems arise with a claim even when the right information is submitted in the wrong format. Still other times, problems stem from the fact that information cannot be accessed when needed—in other words, the insurance company has lost it.
Before you can address the problem, you need to learn precisely what it is. The letter or electronic message from the insurance company may provide at least some clues, so it is helpful to look closely at the communication. Contacting the insurance company for clarification can also be a helpful step.
This is another area where assistance from an attorney often proves invaluable, because a term that has a general meaning in English might have a very specific meaning in the language used by disability insurance professionals. A lawyer who regularly works with these companies will be able to understand the insurer’s communications with greater precision. In addition, when an insurance company receives a question from an attorney representing a policyholder, they tend to take the matter more seriously. It is unfortunate that they do not afford their policyholders the same level of respect, but it is a reality we have seen repeatedly.
If polite inquiries don’t yield an answer that allows us to remedy the deficiency in an application, it may be necessary to take more formal legal action, including initiating litigation. The litigation process allows the use of discovery tools to obtain information that can be essential to resolving a claim and to benefit a policyholder. When choosing a disability insurance attorney to assist with the claims process, it is a good idea to select a legal team with extensive litigation experience. Litigation may proceed to trial, but it often consists of a vital exchange of information and legal arguments that enable each party to understand the strength of the other’s position and facilitate fruitful negotiation and resolution.
Learn More About How Seltzer & Associates Can Help with Your Disability Insurance Claim
Most of our clients are professionals, and many operate their own practices or serve in management roles. Both they and we know that it is vital to keep information organized and accessible and to communicate effectively with those we work with. Having this understanding, it is incredibly frustrating to deal with insurance companies that seem to disregard these essential business practices.
Efficiency and service do not seem to be valued in the insurance business, at least when it comes to handling disability insurance claims. Insurance companies seem determined to try every tactic imaginable to reduce claim values or avoid paying claims entirely, so the inefficiency may be a deliberate delaying tactic.
Regardless of the reason for the problem with a claim, our experienced disability insurance attorneys are prepared to help you resolve the difficulties and recover the full benefits you deserve under your policy. To schedule a free, confidential consultation to discuss the assistance we could provide when filing a claim, investigating a delay, appealing a denial, reinstating terminated benefits, or other challenges, call us at 888-699-4222 or contact us online now.