A Philadelphia Private Disability Attorney Can Assist with Disability Insurance Claims for Professionals

Are you suffering from an injury or sickness that is preventing you from working? Has this injury or sickness limited your ability to work? Can you no longer perform all of your job responsibilities? Does it take you significantly longer to complete your duties? Are you losing money due to injury or sickness? If you are a professional who purchased individual disability insurance, a Philadelphia private disability attorney at Seltzer & Associates can assist you in filing your claim for disability benefits. Properly filing your claim and providing appropriate and necessary “proof of loss” are critical to achieving success in your individual disability insurance claim. Contact us at once to begin the process for submitting your individual disability insurance claim with an experienced Philadelphia private disability attorney.

Understanding the Difference Between Private Disability Insurance Policies and Group Insurance Policies

Many employers offer full-time workers short-term and long-term group disability insurance policies as part of their employee benefits packages. These policies are tied to a specific employer, so if the employee changes jobs or goes out on their own — something many medical professionals and executives end up doing — they cannot take their coverage with them. Group insurance coverage can also change year to year, as can the premiums. The employer chooses which policy to offer its employees, and the terms and conditions for receiving disability insurance benefits. 

Many professionals — especially high-income earners like physicians, dentists, and others in the medical field — opt to carry individual disability insurance either to supplement a group plan or as their primary disability insurance. Having private disability insurance gives high-earning professionals more control over their disability insurance benefits, something many take into account when looking at their disability insurance options. The benefits of purchasing private disability insurance are indisputable, but only if you understand what you are buying and if the policy you choose meets your needs should you ever prove unable to work at the specialty you have trained for. 

Understand The Individual Disability Insurance Policy You Are Buying

If you are trying to decide what type of individual disability insurance to purchase, and you want to make sure that you understand the different options being offered, it is a good idea to sit down with a Philadelphia private disability attorney to go over potential policies and their coverages before making a decision. At Seltzer & Associates, we can help you review prospective new policies by performing a comparison of policies so you can better understand how best to protect your financial needs. Working with your insurance broker, we can assist in providing you with an understanding of the policies you are reviewing for purchase.

For example, individual disability insurance can offer policyholders:

  • More comprehensive benefits because they are individually underwritten
  • Premium costs that won’t go up 
  • Better terms, such as “own occupation,” rather than “any occupation” 
  • Guaranteed coverage (non-cancelable and guaranteed renewable)
  • Set benefits, such as a certain amount a month, rather than an amount tied to income or salary
  • The ability to collect benefits tax-free; employer-based coverage is often considered taxable income

While there are many good reasons to purchase individual short and/or long-term disability insurance, there are also some drawbacks. Private policies can be costly and the terms can be difficult to interpret on your own. You want to avoid a situation where you find out later that the terms of the policy you purchased are not what you understood them to be. 

Before you shell out sums of money on a policy that, if invoked, won’t give you the coverage you need, sit down with an experienced Philadelphia private disability attorney to make sure you understand everything about the policy you are purchasing — including its provisions and requirements and how to go about filing a claim, if necessary. 

Specialty Coverage for Medical Professionals

It is imperative that you understand the claims process, understand your policy provisions and requirements, the defenses that your insurance company will employ in your claim, and receive guidance to take you through this process in the most effective way. Often, physicians, dentists, psychologists, nurse anesthetists, chiropractors, and other medical professionals have individual disability insurance policies which cover your inability to perform your specific occupation or your own specialty. While you may have paid higher premiums for this coverage, when your ability to work in your occupation has been affected by an injury or sickness it is important for you to understand your policy and know what provisions you must satisfy to obligate your disability insurance company to pay you benefits.

Your policy may contain:

  • “Own Occupation” coverage, your inability, due to your injury or sickness, to perform the material and substantial duties of the occupation you were performing when you became disabled.
  • “Modified Own Occupation” coverage, your inability, due to your injury or sickness, to perform the material and substantial duties of the occupation you were performing when you became disabled and not actually working in any other occupation.
  • “Any Occupation” coverage, your inability, due to your injury or sickness, to perform the duties of any gainful occupation for which you are qualified by training, education, or experience.

These provisions can often cause confusion for individuals unfamiliar with them. Additionally, disability insurance companies will often try to construct own occupation for medical professionals as something other than limited to the performance of your clinical medical professional duties, such as an entrepreneur, administrator, lecturer, teacher, or chief of staff , thereby changing or modifying your occupation as covered under your “own occupation” coverage.

We will review your existing policies on a line item basis to help you achieve the best possible understanding of what Individual Disability Insurance coverage you have and when benefits should be payable. We will methodically analyze the definitions in your specific policy and help you understand how those definitions apply to your unique situation. We will help you understand if your are in or considering the claims process and how every policy provision may be employed by your disability insurance company as a potential barrier to paying your claim.

What a Philadelphia Private Disability Attorney Wants You to Know about Submitting a Disability Insurance Claim 

You’re injured or sick and your ability to work has been restricted. You purchased Individual Disability Insurance hoping you would never actually need it, but now you do. It’s time to apply for your disability benefits, do you know how to proceed? Let the team at Seltzer & Associates assist you in this complicated task and guide you through this difficult and complicated claim process.

Don’t Wait Until It Is Too Late

It is important to begin the process of filing your claim for disability benefits as quickly as possible. Your policy will have notice requirements specifying how much time you have to file a claim. Waiting too long can decrease your chances of successfully obtaining Individual Disability Insurance benefits due to your injury or sickness or reduce the amount of benefits you may be able to obtain.

Provide the Appropriate Information

When filing a claim for disability benefits, you are required to provide the insurance company with proof of loss. In an Individual Disability Insurance claim, proof of loss includes statements from you regarding your disability and forms from your doctor explaining how your disabling condition in some way restricts or limits your ability to perform your important duties and earn income. Careful preparation in the early stages of your claim is essential and can help you avoid common, often critical, mistakes in submitting this information. It is essential for you to thoroughly explain your medical condition and occupation. It is most important your company understands and accepts the nexus between your medical condition and how it negatively impacts your ability to perform your material and substantial duties at work.

One of the most significant challenges individuals face in the claims submission process is getting the necessary medical records and information to the disability insurance company. The documentation necessary may be different from your doctor’s standard office notes. We will work with you and your doctor to make sure all necessary and pertinent information is provided to your disability insurance company.

Remember, your claim will be scrutinized by your disability insurance company’s team for any possible defect or inadequacy so as to end in a denial and you must understand all information, from telephone conversations with the company, to medical records submitted, will become part of the disability insurance company’s file. Therefore it is important to have a Philadelphia private disability lawyer, experienced in handling Individual Disability Insurance claims, assist you. We will guide you through the process and help you file your claim in the most effective and strongest possible way with the highest likelihood of being approved and paid by your disability insurance company.

Free Consultations with a Philadelphia Private Disability Attorney

Seltzer & Associates provides an initial consultation of your claim free of charge. Whether you need to file a claim or have had a claim denied or terminated, we can review your policy and pertinent documents for you without financial obligation. We will review the issues specific to your individual situation, including your policy provisions, medical records, and other documents you have on hand.

Individual disability insurance claims are unique to each individual. Your specific occupation, disabling medical condition, and individual policy you purchased require a collective analysis to determine how all of the parts best fit together. At Seltzer & Associates, a Philadelphia individual disability insurance attorney can help you understand the process of claiming individual disability insurance benefits and how to present your claim in the strongest possible way with the highest likelihood of being honored by your disability insurance company.

In addition to reviewing your potential claim, we will begin the process of explaining to you what you can expect to encounter as you engage your disability insurance company in the claims process. We will help you make the most informed and effective decision as to how to proceed in filing your claim and throughout the claims process for your individual disability insurance benefits. If you need assistance in understanding the Individual Disability Insurance policy you have or have any other issue, please contact Seltzer & Associates today for a policy review.