Florida Disability Insurance Claims: The Basics

J.P. Gonzalez-Sirgo
Founder of J.P. Gonzalez-Sirgo, P.A.

Disability insurance comes in many forms depending on the policy.  When policyholders suffer a severe injury, disability insurance companies often employ a range of strategies to deny claims.  Because of the multitude of justifications offered by disability insurance carriers, you should talk to a Miami disability coverage attorney if you have questions about the reasons provided for denial of your claim.  We have provided some basic facts that all policyholders should know about disability insurance policies.


What types of financial loss are covered under disability policies?


While lost income is the most common type of loss covered by disability insurance policies, some policies also cover other types of loss due to disability.  If you own a business, you might want to consider a disability insurance policy that covers business overhead expenses.  Families dependent to a significant degree on income from a business can use this type of coverage, so the business can remain viable during the owner’s period of disability.


Does your disability policy provide disability benefits for life?

While many disability policies pay benefits during the lifetime of the insured, there are some policies that only provide payments until the policyholder turns 65.  Sometimes insurance companies try to persuade a policyholder to accept the resolution of a disputed claim that only provides benefits until 65.  If your insurance company is taking this approach, it will typically take this position early in the process.  If you are faced with this tactic by your insurer, you should seek legal advice from an experienced disability insurance lawyer.

Do policyholders need to be aware of surveillance and ongoing investigations even after a claim is approved?

Once your insurance company has approved your disability claim, you will still be closely monitored for at least 18-24 months.  This scrutiny will include surveillance, physician statement forms, continuing claimant statement forms and even intermittent medical examinations.  An experienced disability insurance claims lawyer can provide legal counsel and guide clients through this post-claim scrutiny to keep their benefits flowing without the need to pursue a lawsuit.

Will my insurance company try to minimize my payments even if it acknowledges that I am disabled?

If your insurance company concedes that you are disabled, the carrier will still try to minimize coverage.  If you are “totally” disabled, the insurance company will owe the maximum disability benefit.  Therefore, the insurance company will often claim you have “residual” rather than total disability.  Residual disability essentially refers to partial disability.  My law firm works diligently to get the maximum benefits possible under a client’s policy.

What types of hoops will the disability carrier typically make you navigate when you submit a claim?

There is a wealth of documents and other procedures that you will need to navigate when making a disability insurance claim like surveillance, physician statement forms, claimant statement forms, independent medical evaluations, field interviews and recorded statements.  This information is requested to justify denying your claim, so you must exercise caution when responding to the insurance company.  My law firm can guide you through the process to help prevent you from compromising your claim.

If you have questions about a disability insurance claim, we are here to help.  My law firm represents policyholders in claims disputes in Miami and throughout Florida.  The Law Firm of J.P. Gonzalez-Sirgo, P.A. offers free consultations and case evaluations.  No Recovery, No Lawyer Fees.  Call 305-461-1095 or Toll Free 1-866-71-CLAIM.

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