Insurance companies are for-profit businesses. They do whatever is in their power to avoid paying you what you are due under your policy. When it comes to disability insurance, the provider knows that they will have to replace a large part of your earnings for an extended period of time. Accordingly, they will not hesitate to deny your claim.
Private disability claims are most often denied because the insurance company believes you do not meet the policy’s definition of disabled, or claims that your medical evidence does not prove you cannot work. From your standpoint, it is important to know exactly why the insurance company has denied your claim, so you can take them on in court.
You Do Not Meet the Policy’s Definition of “Disability”
Once you submit your claim to the insurance company, along with the supporting documentation, the insurance company has 15 days to review your evidence and provide you with an answer. If you are like many other claimants, the insurance company may deny your initial claim and force you to either negotiate a settlement or fight them in court.
An insurance company will deny a private disability claim because they have not seen evidence that shows you meet the plan’s definition of disability. This denial can show up in one of several ways. The first is that the insurance company argues that they have not seen objective medical evidence that shows that you have a disability. Even though you have likely provided the insurance company with both test results and a statement from your doctor, they may still claim that there are not enough tests or documentation to show that you are disabled.
Another way that this denial can occur is that the insurance company may accept the fact that you have a medical condition. However, they may deny your claim because they believe that it is not enough to prevent you from doing your job. The standard for an initial claim is that you must show that you cannot perform the duties of your own job. The insurance company may review vocational evidence and your medical information and reach a different conclusion than you did.
Other Reasons Why Your Disability Claim Is Denied
The insurance company may deny your claim for other reasons, including:
- You missed the deadline to file a claim, or there were errors in your paperwork
- You did not cooperate with the investigation that the insurance company performed
- Your medical condition existed before you purchased the disability insurance policy
- You have not consistently sought medical treatment for your conditions or followed a doctor’s recommendations
- Your medical records note that there is some improvement in your condition
Contact a Houston Disability Attorney
When the insurance company wrongfully denies your claim, they have broken a contract that they have with you. Then, you can sue them in state court. At Raval Trial Law, we can represent you as you fight back against wrongful insurance company conduct. The first step towards getting what you deserve comes when you schedule an initial consultation. Call us today at (713) 324-8118 or visit our website to speak to our disability lawyer.
