Top 3 Reasons Why Your Disability Benefits May Be Denied

Receiving a disability insurance claim denial can be overwhelming. You are already facing medical issues, time away from work, and uncertainty about the future. You do not need to add appealing your disability claim to the list. Disability insurance is supposed to relieve some of the stress experienced in times of disability by providing financial security to you and your family.

Seltzer & Associates treat our medical and dental professionals with dignity and respect. You will not be brushed off because of a common condition. We understand that your disability insurance benefits may be the key to future financial security when your ability to work is limited. 

There are several reasons why your claim for disability insurance benefits may be denied. Some tactics are frequently used to limit the number of claims disability insurance companies have to pay. We strongly believe that insurance companies should not be free to make business decisions at the expense of insureds with meritorious claims.

Notification and Communication With Your Disability Insurance Company

Disability insurance policies contain specific notice and proof requirements. When certain burdens are not met, the insurance company may seize this opportunity to deny or terminate your disability insurance benefits. A Philadelphia disability insurance attorney can help you by responding to the insurance company on your behalf and fighting any unreasonable denials or terminations that come your way.

Lack of Objective or Quantifiable Evidence of Disability

Generally, insurance companies will demand that you meet your burden of proving your disability claim before it is approved. Medically, the best way to prove your claim may be with objective evidence or data. For example, diagnostic imaging such as x-rays, MRIs, and CT scans can show broken bones, torn muscles, and damaged organs, providing clear proof of illness or injury to the insurance company. However, not all disabling conditions are so clear-cut.  Some disabling medical conditions cause inherently subjective symptoms. Mental health conditions, addiction, and conditions causing pain are more difficult to prove with objective evidence. Without objective evidence, a disability insurance company may deny or terminate benefits, even where the insured is suffering from a known medical condition. An experienced Philadelphia disability insurance attorney knows how to fight these insurance companies to secure your disability insurance benefits. 

You will also need to continue seeking appropriate care for your medical condition. You must meet your contractual burden of obtaining regular care that appropriately addresses your disabling condition in accordance with the applicable medical standards. Gaps in treatment may be inconsistent with the severity of your condition and give the insurance company an opportunity to deny or terminate your benefits. Working with a Philadelphia disability insurance attorney can help keep your claim on track and avoid disruptions to your benefits.

Pre-Existing Conditions 

If your disability insurance policy is relatively new, and you have been treated for a condition causing or contributing to your disability, your insurance company may have a contractual basis for denying your claim. Pre-existing conditions clauses in disability insurance contracts can be ambiguous and open to multiple interpretations. For this reason, if your denial is in any way related to a pre-existing condition, you need to contact a Philadelphia disability insurance attorney as soon as possible.

Schedule Your Free Consultation with a Philadelphia Disability Insurance Attorney

Seltzer & Associates has experience working with insurance companies nationwide to secure disability insurance benefits for our clients. If your disability insurance benefits have been denied or terminated, you need to schedule a free consultation with a Philadelphia disability insurance attorney to fight your denial. Contact Seltzer & Associates by calling 888-699-4222 or completing our online contact form.