Top Ten Reasons for Denial 2014-03-27T21:40:20+00:00

Top Ten Reasons for Long Term Disability Insurance Denial

Beware of these Top Ten tactics used by the insurance companies to deny or underpay long term disability insurance claims!

  1. YOU ARE ERISA PREEMPTED. BECAUSE YOU OBTAINED YOUR DISABILITY INSURANCE AT WORK, IT MAKES NO DIFFERENCE HOW DISABLED YOU ARE, OR WHAT YOU CAN NO LONGER  DO. FURTHERMORE, IT MAKES NO DIFFERENCE IF YOU HAVE BEEN BANKRUPTED, DESTROYED, RUINED AND RENDERED HOMELESS AS A RESULT OF THE WRONGFUL DENIAL OF YOUR CLAIM. YOU CAN’T SUE US FOR BAD FAITH, FRAUD OR ANY SUCH THING. WE ARE IMMUNE FROM ALL OF THAT. SIMPLY IMMUNE. THAT’S THE LAW. IF YOU DON’T LIKE IT, HIRE A TEAM OF LOBBYISTS. WE’LL SEE YOU IN D.C.

 

2. YOU MAY BE PARTIALLY – BUT NOT TOTALLY DISABLED. “TOTAL DISABILITY” IS DEFINED IN YOUR POLICY AS YOUR “INABILITY TO PERFORM THE IMPORTANT DUTIES OF YOUR OWN OCCUPATION.” “RESIDUAL DISABILITY” IS DEFINED AS YOUR “INABILITY TO PERFORM SOME OF THE IMPORTANT DUTIES OF YOUR OCCUPATION.” THIS MAY SEEM CONFUSING TO YOU AS A LAYMAN, BUT THE BOTTOM LINE IS THAT RESIDUAL PAYS ABOUT 25% OF WHAT WE WOULD OWE YOU UNDER TOTAL. ENCLOSED IS YOUR RESIDUAL DISABILITY CHECK FOR LAST MONTH. IF YOU HAVE ANY QUESTIONS, PLEASE CALL OUR CUSTOMER CARE HOTLINE RECORDING. AND REMEMBER, YOUR CALL IS IMPORTANT TO US.

 

3. FIBROMYALGIA AND RHEUMATOID ARTHRITIS NOT WITHSTANDING . . .OUR VIDEOGRAPHER INADVERTENTLY DISCOVERED  THAT YOU SEEM TO BE SPENDING CONSIDERABLE TIME IN THE COMPANY OF A CERTAIN SALLY WILLOPE. WE MUST SADLY ADVISE THAT IF YOU PURSUE YOUR CLAIM THIS UNFORTUNATE SITUATION WILL UNDOUBTEDLY SURFACE AS ONE OF THE REASONS YOU ARE NO LONGER SHOWING UP AT THE OFFICE. LORD KNOWS HOW A JURY – OR YOUR WIFE – MIGHT RESPOND.

 

4. YOU DO NOT MEET THE DEFINITION OF DISABILITY IN YOUR POLICY. WE DEFINE TOTALLY DISABLED AS THE INABILITY TO PERFORM ALL OF YOUR IMPORTANT DUTIES. ONE OF YOUR DUTIES IS TO REPORT TO WORK AT 9 AM. YOU CAN STILL DO THAT, AND THEREFORE YOU ARE NOT TOTALLY DISABLED.

 

5. OUR MEDICAL PROFESSIONALS DISAGREE WITH YOUR TREATING PHYSICIANS. OUR IN-HOUSE PODIATRIST HAS REVIEWED YOUR PSYCHIATRIC DIAGNOSIS OF BI-POLAR DISORDER AND CLINICAL DEPRESSION AND FINDS ‘NO BASIS FOR THE FUNCTIONAL IMPAIRMENTS CLAIMED.”

 

6. DELEGATE. YOU’RE THE BOSS. HAVE A SUBORDINATE PERFORM THE DIFFICULT PROCEDURES WHILE YOU SUPERVISE FROM THE COMFORT OF AN ERGONOMIC CHAIR.

 

7. YOU COULD WORK IF YOU REALLY WANTED TO. EVEN DEAFNESS DIDN’T STOP LUDWIG VON BEETHOVEN.

 

8. CHOICE, NOT IMPAIRMENT. YOU TOLD OUR PRIVATE INVESTIGATOR THAT YOU WOULD RATHER BE PLAYING GOLF THAN WORKING AS AN ER DOCTOR. YOU ARE BURNED OUT IN YOUR JOB AND SIMPLY WANT TO RETIRE.

 

9. EXAGGERATING SYMPTOMS. WE HAVE SURVEILLANCE FILMS OF YOU CARRYING A BAG OF GROCERIES FROM A SUPERMARKET TO YOUR CAR. IF YOU CAN CARRY GROCERIES YOU CAN (FILL IN THE BLANK – PERFORM NEURO-SURGERY; OPERATE HEAVY EQUIPMENT; PROGRAM COMPUTERS; PERFORM YOUR DUTIES AS A CHIROPRACTOR . . .). WE HAVE CONCLUDED THAT YOU ARE “MALINGERING,” MALINGERING IS NOT A DISABILITY.

 

10. CONCEALMENT ON YOUR DISABILITY INSURANCE APPLICATION. YOU LEFT OUT ONE NAME ON YOUR LIST OF DOCTORS THAT YOU HAVE SEEN IN THE LAST TEN YEARS. THEREFORE WE HAVE THE RIGHT TO “RESCIND” (ELIMINATE) YOUR POLICY BASED ON YOUR “NON DISCLOSURE OF A MATERIAL FACT.”

 

Related blog post: Why Long-Term Disability Insurers Say “No”