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Why an insurer may deny a long-term disability claim

On Behalf of | Feb 13, 2023 | Employment Law -- Employee |

Disability insurance through an employer is a safety net that offers employees considerable peace of mind. If workers sustain disabling injuries or become ill to the point where they cannot work for six months or more, such insurance will help them financially.

According to the Centers for Disease Control and Prevention, over a quarter of the nation’s population live with some form of disability today. Fortunately, many are provided benefits through long-term disability. However, there are circumstances that may lead to the denial of a claim.

A legitimate reason

Insurers may reject a claim if there is not enough medical evidence to support it. There needs to be sufficient information to determine the worker’s disabled status. They may also deny one if the applicant misses an important deadline or fails to meet all required terms. There are timelines for reporting incidents and turning in the proper documentation.

Simple bad faith

An insurance company may also act in bad faith. This means it may reject a claim without giving a reason, simply because it doesn’t want to pay out benefits. It may also purposefully delay proceedings or hold back vital information. An adjustor may also try to offer a smaller sum than appropriate just to settle the claim.

Individuals have the right to appeal a disability insurance claim denial. A rejection is not the end of the line, especially when bad faith takes place. Seeking guidance from a legal professional who knows the law is advised.