Disability Insurers and the Claim Process
Each year, many Americans are disabled as the result of an accident causing them injury. There are many different elements that could be taken into consideration in a disability case and making a claim. For instance, if one is seeking a long-term disability claim, there are three main elements that are typically taken into consideration: What is the disease or injury that left you disabled? How does that disease or injury result in restrictions and limitations in your ability to complete work? How do those restrictions and limitations translate into you being unable to do your job? Disabilities could lead to very complex laws when you are looking at filing a claim.
Disability insurance can be a very vital thing to a worker. It provides benefits and protections to workers, but when it comes to obtaining those benefits, a long and complicated process can come into play. There are certain factors that need to be considered for the benefits to be reaped. For instance, one must consider the worker’s type of disability insurance policy, the policy or plan’s terms, and whether the insurance comes from an employer or is an individual policy.
So, How do I File a Claim?
The first step involved in receiving the disability benefits you deserve includes filing a claim with the disability insurer. How is this done? Typically, a policyholder will be held responsible to fill out a form describing injuries and job responsibilities. They will also need to include their salary and other important financial information. The policy holder’s doctor must submit a statement detailing the worker’s injury, describing a treatment plan, and verifying that the worker is not able to return to work with the current injury. After the claim is submitted, the insurance company has to choose whether or not they will approve the claim for benefits.
What if my Claim is Denied?
There are many different reasons in which a disability insurer may deny a claim. The type of disability insurance and the terms applying to the policy could make all the difference when it comes to receiving the benefits you deserve. For instance, if a worker obtained his insurance through an employee benefits package, then federal law requires that person to follow a strict administrative process to appeal the denial before filing a lawsuit to demand benefits. The benefits received will depend on the situation at hand.
If an Appeal Fails, What Happens Next?
When it comes to private insurance, a policyholder can usually file a standard lawsuit with a trial where he or she is able to present evidence and call witnesses to stand. However, federal law may become involved in lawsuits regarding employer-provided disability insurance. A judge may end up giving the most weight to the information within the policyholder’s file, which will contain all of the documents and paperwork relating to the claim and appeal. Providing a great amount of information will always land you on top.
If you feel like you have a disability claim, you may find that it can be a long and difficult process to receive the benefits that you deserve. You may want to consult with an attorney today to file your claim. Call your attorney at MDL today to schedule a free consultation.