Disability Insurance Types of Denials

Do you meet the definition of "disability"? You do not have to be bedridden to qualify. All you must show is that you meet the following definition: You are prevented from working with reasonable continuity in your customary occupation, or another occupation in which you could reasonably be expected to perform satisfactorily in light of your age, education, training, experience, station in life, physical and mental capacity. It does not matter that you can perform your duties some days and some days you cannot. You must be able to perform the basic duties of your job continuously from day to day.

Pre-existing condition
You must disclose any past medical history. If a claim is denied for this reason, look to your policy for a "no contest clause" which prohibits a company from denying a claim if the policy has been in effect for a period of time. Remember, if you failed to provide information which was important (or that a lay person would have believed was important) the company will likely deny the claim. How do you know what is important? Answer this: if the company had been aware of the circumstances, would they have issued the policy?

Insurance Company Tactics
Insurance companies use a number of techniques to avoid paying disabled professionals:

1. As discussed above denying a claim to simply to wear the claimant down to a lower settlement using protracted and costly lawsuits.
   
2. Using harassing tactics such as repeated requests for independent medical examinations. Often procuring opinions from people inexperienced with the medical condition at issue and using these unqualified opinions to deny the claimed disability.
   
3. Or they may take the opposite approach and simply deny claims without any independent medical examination.
   
4. Use of detectives and surveillance in an effort to discredit the disability and deny the claim. This can involve interviewing co-workers, friends, and neighbors.
   
5. The company may use pressure tactics to get the claimant to surrender their professional license.
   
6. Outright denial of claims involving certain diseases including mental disorders, fibromyalgia, and chronic fatigue syndrome.
   
7. Partial payment on a claim for total disability.
   
8. Claiming a late premium and lapsing the policy.
   
9. Arguing the disability is the result of a pre-existing condition.
   
10. Alleging a misstatement invalidates the policy.
    

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