There are so many reasons an Insurance carrier can decide to deny a claim for Long Term Disability benefits. There are those reasons that they use to deny on the surface and cite in a denial letter and there are those internal reasons which motivate the insurance companies to deny that you will not be given.
The reasons an insurance company may cite for denying Long Term Disability claims include that the claimant is not disabled, the existence of a pre-existing condition, the running of the applicable statute of limitations, failure to provide medical evidence, and the list goes on. Long Term Disability plans usually have a list of exclusions which 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.
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.
If you have any questions about the denial of your short Term or Long Term Disability claim, please give us a call. We are available at 407-839-0005 or, toll free, 844-454-59995. After discussing your case, we can set an office conference, if you would like.
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 as well as claims arising under private disability policies.