QUESTION: I haven’t filed a claim yet. When should a Long Term Disability Claims Consultant get involved?
NOW! The sooner you engage the services of a Long Term Disability Consultant (LTDC), the better your chances of receiving the maximum benefits to which you are entitled. Most claims do not require an attorney’s help, but many are “lost” long before the insurer even receives your request. We can help you avoid those costly, and often irreversible, mistakes.
QUESTION: What types of assistance do Long Term Disability Consultants provide?
As long term disability claims consultants with years of experience within the insurance industry itself, Health Resources Consultants, Inc (HRC) can -
- Analyze your policy(ies), identify and explain relevant definitions and policy provisions as your insurer may interpret them, all in language you can understand.
- Help determine what medical and other documentation is relevant to your specific claim as well as counsel you about when and how to best present that information to your insurer(s).
- Assist you in completing applications to avoid mistakes or omissions as well as in preparing a detailed and successful job description, a critical document in the assessment of disability claims.
QUESTION: Isn’t it possible that if I file my claims on my own, I may not encounter problems receiving my disability benefits?
Yes that is always possible and many claimants elect to go that route. However, keep these things in mind:
- Most claim problems occur because long term disability policyholders have a wide array of professional backgrounds. They are experts in their professions, but have no experience maneuvering the disability health care maze.
- The claims filing process is time consuming, but it is easier and less costly in the long run to take the steps necessary to establish a solid foundation at the onset of a claim than to have to appeal one that has already been declined.
- Without the knowledge and guidance needed to understand where potential claim problems may lie, claimants will not know in advance how to avoid them, thereby leading to possible litigation that may take months or even years to resolve.
- Most policyholders cringe, become anxious or fearful at even the thought of having to read their long-term disability policy(ies). It becomes a matter of necessity, however, if you suddenly become disabled or are nearing a point where you know an existing condition(s) will prevent you from being able to continue working, and details are often overlooked under those circumstances. That’s when a professional long term disability connsultant’s advice is most needed!
QUESTION: What can I do if my claim is denied?
- Realize that insurance companies must deny all claims in writing.
- Claimants have the right to request a written statement including the specific policy provision(s) (including page and paragraph) that supports the claim denial.
- To prepare a suitable appeal, you must understand the contractual basis of the denial and clearly understand specifically what is needed to appeal and reverse a denial.
- If you don’t know how to undertake this challenge, consider seeking the help of a professional long term disability consultant who can work with you to determine what documentation needs to be provided and what’s the most efficient and effective method of presenting your case.
QUESTION: If my claim is approved, what’s next?
Carefully review the following:
- What did the insurance company write in the letter accompanying the check?
- What additional information are they requesting?
- When do they want it and do you understand why they’re requesting it?
- Does their letter say the company is reserving their rights even though they are making a payment?
If so be aware this could be the start of a problem. Stay alert!
- Then, if everything seems okay, get the check to the bank and cash it ASAP!
- As the claim proceeds always ask yourself if the information they are requesting makes sense to you or do you feel that these questions are designed to invalidate your claim?
- If the latter, keep in mind that a little paranoia that wards off complacency may help prevent costly errors that could jeopardize your future benefits. Remember that even after you’ve deposited the first check, that’s no assurance that these benefits will continue without further investigation.
- If you find yourself in trouble, don’t let the second shoe drop before getting professional help that may enable you to keep both shoes on in the final analysis!
QUESTION: How do I manage continuance of disability forms?
Insurance companies can be a real nuisance if they request Continuance of Disability forms on a frequent basis. With claimants who have chronic or progressive conditions, these forms shouldn’t be necessary, but most insurance companies don’t offer to ease this burden for you.
Claimants need to understand:
- What they can proactively do to reduce the number of these requests
- How to limit the requests to one or two continuance forms a year
- When you have reduced the requests to one a year, consider yourself a WINNER!