Most Long Term Disability policies I have reviewed over the years include mental illness limitation provisions, restricting the period of time benefits are payable on claims involving mental or nervous conditions, such as anxiety, depression, and more. Often, insurance companies try to expand the definition of these limitations to their broadest scope.
Types of Clauses in Mental Illness Limitations
There are two main types of mental illness clauses. The first limits benefits only if the mental condition is the primary cause of disability, a preferable option. However, insurers may still try to apply this limit to claims based on physical conditions with minor psychological elements.
Limitations Based on Contribution from Mental Conditions
The second clause limits benefits if a mental condition contributes to the disability in any way. If your policy includes this clause, proceed cautiously, as insurers may use even minor evidence of mental health treatment to restrict benefits.
Broad Definitions and Their Impact on Claims
Insurers often employ broad definitions for mental illness, arguing that these conditions are difficult to assess due to subjective symptoms. While some policies exclude specific, diagnosable conditions, most use overly expansive definitions that may unfairly deny benefits to claimants without a history of perfect health.
Defending Your Claim Against Policy Pigeonholing
If your claim faces limitations due to mental illness provisions, the attorneys at Herbert M. Hill, P.A. have experience countering these tactics. Contacting a dedicated long-term disability attorney can protect your rights and ensure fair treatment under your policy.
The Importance of Specialized Legal Support
Long Term Disability claims form the core of our practice at Herbert M. Hill, P.A. We do not represent insurance companies, and we are dedicated to defending the rights of claimants. Contact us for a free consultation to discuss your claim with our team.
Get in Touch with Us
Herbert M. Hill, P.A. offers extensive experience across Florida in handling disability insurance claims, ERISA benefits, and a variety of employee benefit claims. Contact us to discuss your case.
