When you have paid your disability insurance premiums month after month, you have a reasonable expectation that the insurance company will be there to help pay your expenses if you face a devastating loss, like an illness that stops you from working. Unfortunately, not all insurance companies operate fairly with their customers—and claims will get denied in an attempt to improve the company's financial bottom line. How can you tell if you may be heading toward a problem with your disability insurer? Here are three signs you need a lawyer.
1.) You can't get any clarification of the terms of your policy.
Disability insurance policies can be difficult to understand, and many people don't pay a lot of attention to the fine details until they're in the middle of a situation in which they need to make a claim. If you're having trouble understanding something about how the determination is made on your case and when you can expect payment, it shouldn't be hard to get a plain-English explanation of your benefits. If you can't get a clear answer to simple questions, that could be the first indicator of a problem.
2.) The claims adjuster suggests that you aren't really that sick or should try working.
Claims adjusters aren't doctors—but that doesn't stop some of them from suggesting that your condition isn't really as bad as you think it is or suggesting that you should try returning to work in spite of your condition. If the claims adjuster is rude, dismissive, or seems to be subtly threatening to deny your claim because you aren't "trying" hard enough to work, that's a clear sign of trouble.
3.) The company uses delaying tactics to avoid paying your claim.
There are a number of tactics that insurance companies can use in order to delay paying your claim:
- denying your claim almost immediately without any clear explanation
- asking for irrelevant documentation, like extremely old medical records
- not returning your calls, emails, or letters
- switching your claim from one adjuster to another and telling you that your claim is going to be delayed because of the change
- offering you payment for only part of the time you were unable to work, with no explanation or one that seems contrary to your insurance policy's terms
- sending you sporadic payments without explanation of the delay
- refusing to accept medical documentation you offer and not contacting your doctor for evidence in a timely manner
In part, this is just to discourage you from trying to assert your rights, but it also serves another purpose: it could deprive you of the ability to file a lawsuit against them. If the company successfully delays your claim long enough, you could inadvertently let the statute of limitations expire—which means you can't sue the insurance company in order to get what you're owed.
If you're experiencing any of these tactics, don't allow your claim to fall to the wayside or get pushed past the statute of limitations. Insurance companies that operate in bad faith count on the idea that most people will give up, especially once they've recovered and managed to return to work. Even if you're doing better now, you're still owed payment for the time you were disabled. Contact an attorney, such as one at Bidegaray Law Firm LLP, who handles insurance denial claims in order to discuss your case.