Representing Florida Employees in Work Issues

3 reasons your disability insurance claim might get denied

On Behalf of | Aug 7, 2023 | Disability Benefits |

Individuals could face a disability at any time. In many cases, it prevents them from earning a living. Many have disability insurance policies to cover living expenses in the event that are out of work and cannot earn a paycheck. Unfortunately, some who make a claim do not receive a favorable response.

Understanding the common reasons for denied applications may enhance your chances of making a successful claim. Below are top 3 reasons claims often get denied:

1. Pre-existing conditions

Certain medical conditions increase your risk of becoming ill or suffering disabling injuries, which can affect the outcome of your disability insurance claim. These conditions may include:

  • Cancer
  • AIDS
  • Hepatitis
  • Multiple sclerosis
  • COVID-19

Generally, disabling injuries that result from these conditions might bar individuals from recovering disability insurance coverage. This is often included in the policy’s provisions but not always.

2. Proof of loss

Your proof of loss refers to the documents that prove you have an illness or injury that qualifies you for disability insurance benefits. These often include your medical records and claim forms. There is usually a deadline for submitting your proof of loss, missing this usually results in a denied claim.

3. Objective evidence

It is not enough to claim you have a disability; you also need to provide objective evidence supporting your claim. You should submit your doctor’s diagnosis of your disability, along with supporting laboratory and imaging tests that describe and measure your condition. Furthermore, your doctor should explain why you cannot work and estimate how long your impairment is likely to last.

Getting a denied for much-needed disability insurance can be frustrating. However, as a policyholder you have rights. If you believe your insurer denied your claim unjustly, a lawyer with knowledge handling these claims can assess your situation and provide guidance on the law and next steps.

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