Philadelphia Short Term Disability Insurance Appeals Attorney for Benefit Denials
Short-term disability insurance is typically designed to provide a weekly income protection benefit for a limited period of time. The policies cover injuries and illnesses that prevent or limit your ability to work and perform your principal occupational duties. Typically, the idea behind short-term disability insurance is to give you the time to focus on your health or recovery without having to be burdened by financial concerns. Sometimes, when a long-term disability policy is being invoked, you can use your short-term disability benefits to get you through the elimination period before those benefits kick in. Too often, however, legitimate short-term disability claims are denied by insurance companies seeking to save money. A Philadelphia short term disability insurance denial lawyer can help you appeal the insurance company’s wrongful denial of your claim.
What Can You Do to Appeal a Disability Insurance Claim Denial?
There are several steps you can take to appeal a denial of your short-term disability claim.
- Identify the reason your claim was denied. Your insurance company will send you a denial letter, which will set forth its reasons for denying your claim. Read this letter carefully. Often the reason cited is a technical one — a coding mistake or missing information — that will be easy to address. Other times, however, the denial will be because the insurance company disputes your eligibility on other grounds — alleging the illness you claim is not covered, for instance — and that may require the assistance of a Philadelphia short term disability insurance appeals attorney to sort out.
- Review your policy’s procedures for filing appeals, including the deadlines. The deadline for filing the appeal will typically be 180 days, but you want to make note of the exact date set forth in the denial letter. If you are unclear about the deadline, contact the insurance company for clarification. If you miss the deadline, you will likely lose your right to contest the insurance company decision.
- Review the information the insurance company has on file. If the denial was based on anything other than a simple clerical error in the original claim form filing, you need to find out precisely what information the insurance company relied upon in issuing its denial. To do this, you will need to request a copy of the administrative file. Ask that expedited copies be sent to you as soon as possible.
- Gather all the information you will need to support your appeal. Depending on your review of the insurance company’s file, you may want to gather additional documentation from your treating physician, a second opinion from another provider, and even written observations by colleagues if they can help strengthen your case for benefits. If you experienced some sort of trauma — such as a car or other type of accident — documentation like police reports and witness statements can also be helpful.
- Draft a detailed appeals letter and send it before the deadline. It is important for you to understand that you are only entitled to one appeal. As you are only entitled to one appeal, it is important that you clearly set forth all the information supporting your appeal in a persuasive letter or on the form that the insurance company provides. Documentation should be clearly labeled and referenced in the appeal. If you have not already done so, consulting with a Philadelphia short term disability insurance denial lawyer before sending in the appeal is recommended to ensure your rights are protected. The last thing you want is for your appeal to be denied based on either a technicality or your failure to provide all the evidence at your disposal in support of your claim.
Contact a Philadelphia Short Term Disability Insurance Appeals Attorney
Every Philadelphia short-term disability insurance denial lawyer at Seltzer & Associates has had great success appealing short-term disability claims denials on behalf of doctors and other medical professionals. If an appeal is denied, our experienced litigation team can work to resolve the case through mediation or, as a last resort, through court proceedings. To learn more and for a free assessment of your case, contact our offices today by calling 888-699-4222.