Insurance claims examiners can make mistakes in interpreting the meaning of the contract provisions, but it is also important to remember that it is the insurance company that drafted the contract terms. Thus, regardless of how seemingly “good” the policy is, terms within the policy are drafted in an ambiguous manner to allow the insurance company flexibility in determining eligibility for a claim. While it can be positive for a policy to allow flexibility in claims handling procedures, insurance companies often abuse this flexibility to create an unfair advantage and save money by denying claims.
Many professionals quickly, and often carelessly, complete the application forms and respond to insurance company information requests, unaware of the importance of the initial application process. This coupled with ambiguous policy terms can be devastating to their claim. It is essential to take the time to understand the entire disability insurance contract, thoroughly review all application materials, and pay special attention to the wording chosen when completing all forms.
Problems that arise with disability insurance claims can many times be avoided if a claim is handled appropriately from the beginning, with a solid understanding of the legal meaning of the disability insurance contract terms and the information necessary to proving entitlement to benefits. Legal representation becomes even more necessary and costly when you are faced with a denial of benefits, and too often the damage done early on in a claim cannot be overcome in the appeals process and necessitates lengthy litigation.
The question remains whether you are truly insured against disability in your medical specialty. Determining the answer to this question before it is too late is critical to the success of any disability insurance claim you are faced with filing under already unfortunate circumstances.
Attorney Maggie M. Smith is a partner with Disability Insurance Law Group (DI Law Group) which focuses its practice on handling individual and group disability insurance claims at all stages of the process. Maggie M. Smith, Esq. can be reached at firstname.lastname@example.org, (888) 644-2644 or through the firm’s website at www.dilawgroup.com.