Even when you the foresight to have taken the precaution of obtaining disability insurance coverage, obtaining payment of the benefits from your insurance company is sometimes difficult. Disability claims may be denied by the insurance company due to a perceived lack of coverage for the specific medical conditions you have, if you are able to continue working, or even if your physician does not promptly forward medical reports to the carrier. Sometimes insurance adjusters are simply overwhelmed or don’t understand your problems well enough to make a proper determination of coverage. Other times, the carrier may conduct "post-claims underwriting” or otherwise utilize improper claims handling practices to deny a claim.

One thing an insured needs to remember is that any false statement or even an innocent misstatement in the application for insurance or any claim form may be used as a basis to deny your claim.

When you know you have a disability, immediately file your claim. The longer the delay in letting the insurer know of your condition and claim, the greater the likelihood the insurer will deny your claim. Ask your doctor to provide you with a written explanation of your disability. Present that to the insurer when you make the claim. In addition, ask your agent to explain your policy to you, and provide them with a copy of all claim materials. Keep a copy of your application and make sure all information on your application is truthful. Go over it with your agent. If there are inconsistencies or misstatements in the application, they will eventually be brought to your attention by the company. In that case, be able to provide a truthful explanation as to why the inconsistencies are present.

Keep copies of all correspondence with your insurer along with all other documents you send to them, or receive from them. If you talk with the company, your agent or another claim professional telephonically, make detailed notes of your conversation. If you call the Company, write it down, even if all you did was leave a message. Try to confirm any conversation in writing. If you have left several messages and they have not responded, write and tell them. Then, if they later try to say they were always responsive to your calls and letters, and if that is not accurate, you have a record showing them to be incorrect. It will also make it more difficult for them to deny making a statement to you that is material to your claim.

The insurance attorneys at Pilka & Associates can assist you if your insurance company wrongfully denies or delays your claim, or if it attempts to pay you less than you are entitled under your disability policy.

Make an appointment today by telephone.

Brandon, Florida (813) 653-3800
Lakeland, Florida (863) 687-0780