Long Term Disability Insurance Claims: The Basics

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

Long term disability insurance coverage is available in several forms.  When policyholders suffer a severe injury or illness, disability insurance companies often employ a range of strategies to deny claims.  Below we provide some basic facts that all policyholders should know about disability insurance policies.

What types of financial loss are covered under disability insurance 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 some disability policies pay benefits during the lifetime of the insured, there are many policies that only provide payments until the policyholder turns 65.  

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.  This scrutiny will include surveillance, physician statement forms, continuing claimant statement forms and even intermittent medical examinations.  

Will your insurance company try to minimize your payments even if it acknowledges that you are 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. 

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.  

You can reach Miami Long Term Disability Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

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