The Next Five Reasons an Insurance Company Will Deny Your Long-Term Disability Claim [Video]

By Roger Foisy
on September 04, 2013

In our previous video, we explained the first five reasons why an insurance company might deny your long-term disability claim or terminate your benefits. Click here to see it.

Today, our video is concerned with the next five common reasons why insurance companies deny long-term disability claims. If you are unable to work because of an injury or illness, it is crucial to be aware of the reasons why insurance companies deny claims.

1. Objective Evidence or Insufficient Information

If a claim for long-term disability benefits has little or no objective evidence and/or insufficient medical information to support the disability, it will be denied. Therefore, it is important to precisely describe how your injury or illness impacts your daily activities when seeing your doctor or specialist.

Evidence may include lab results, consultation reports, MRIs, ECGs, psychological assessments, etc.

2. Treatment and Assessment Compliance

You must be under medical care and comply with the rehabilitation program for your disability. This means regularly attending doctor appointments, seeing recommended specialists, and taking medication as prescribed. Failure to demonstrate compliance with your treatment will result in a denied claim or the termination of your benefits.

3. Contradictory Surveillance

Insurance companies sometimes perform surveillance with a private investigator when a disability insurance claim is made or just prior to the re-evaluation period for disability benefits.  Evidence gained through this surveillance can be used to show that the claimant in question is fit to work.

4. Contradictory Online Evidence

Insurance companies frequently deny claims and terminate benefits because of contradictory evidence gained from social media or networking sites such as Facebook. Photos or videos of claimants engaging in social events, vacationing, or participating in strenuous sports and recreational activities can be used as evidence to dispute a disability claim.

5. Meeting Disability Definitions

The most common reason for denial of disability insurance claims is failure to meet the current definition of disability. Although the definition of disability may vary in different contexts and policies, disability is generally defined as: an injury or illness that makes a claimant unable to do all or almost all of the essential duties required for their job.

Usually after 2 years of receiving disability benefits, the claimant will only qualify if they are unable to perform any occupation for which they are reasonably qualified (by means of education, training, and experience).

Unfortunately, many people face denied claims and termination of long-term disability benefits every day. Knowing the common reasons for denial can help you receive the benefits you need to aid with your recovery process.

If you should choose to sue your insurance company, you should seek an experienced disability claims lawyer to guide you through the various legal processes and help you get the compensation you deserve.

>> Roger R. Foisy is an experienced Personal Injury Lawyer who can help you through the process and handle your long-term disability claim. Do not hesitate to contact us today for immediate support and a free consolation.

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How Foisy & Associates Can Help

At Foisy & Associates, we understand the emotional and financial challenges you face after losing a loved one in a fatal accident. Our team is committed to providing the compassionate, expert legal support you need to navigate this difficult time. We offer a delicate yet committed approach to ensuring you receive the compensation you deserve. Our experience in Ontario fatality law allows us to guide you through the legal process with respect and empathy, so you can focus on healing while we handle the complexities of your case.

If we have not addressed your question here, please visit our FAQ page for more details. Additionally, if you have lost a loved one in a motor vehicle accident and need support in making a claim against the at-fault party’s insurance company, please contact us for a free consultation. Our team at Foisy & Associates is ready to provide you with the guidance and legal expertise you need to secure the compensation you and your family deserve.