Insurance carriers have a multitude of reasons for denying claims for Long Term Disability benefits, including both the overt ones they cite in the denial letter and the undisclosed internal motivations leading to a “Long Term Disability denied” decision.
If your Long Term Disability claim has been denied, you can look to your denial letter for an explanation. The insurance company may cite any of these reasons for denying your claim:
Pre-existing conditon
Claiming that you are not actually disabled
The statute of limitations has run out
There was a failure to provide adequate medical evidence
And others
There are many reasons an insurance company may cite for denying Long Term Disability claims. Long Term Disability plans usually have a list of exclusions that can be used against you in order to avoid paying your claim. Some of these exclusions may be set in stone and will act to disqualify you out of the gate. Speaking with a Long Term Disability attorney can help clarify if there is any leeway in your claim status and if an appeal is appropriate.
Internal Motivations
Internal motivations to deny claims can be varied and have nothing to do with you or your specific disability. Your claim may have come up right when a claims representative was facing a quota, and the cost to administer your claim, in addition to the years of disability benefit payments, caused the representative to deny your claim. If you are young and have many years until your retirement age, which would likely be the time until the insurance company would be required to pay benefits, the insurance company would likely be motivated to deny your claim as they would owe you substantially more than if you are closer to retirement age.
Herbert M. Hill, P.A. Can Help
If you have any questions about the denial of your Short Term or Long Term Disability claim, please contact our office. We can schedule a complimentary consultation to discuss your case. When you have questions like “Why was my Long Term Disability denied?” we have the answers, and we can guide you through the process toward getting the benefits you are entitled to.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida, with a practice extending throughout the state of Florida. While the vast majority of cases handled are for disability insurance benefits, areas of practice include employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (“ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements, or the like, and claims arising under private disability policies.
