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Most insurance companies who administer group Long Term Disability (“LTD”) Plans are well known for the often extraordinary lengths that they go to in order to deny or terminate claims. I attempt to counter the insurance company’s tactics by overwhelming them from the outset.
I represent a 39 year old who could no longer work as a floor trader because of knee impairments. Despite some irrelevant information demands from the insurance company, I succeeded in getting the claimant’s LTD application approved in less than months after it was filed. I did so by providing more information than was required when applying. Whereas the application only required an Attending Physician Statement (“APS”) as medical proof, I submitted three, as well diagnostic test data and functional capacity information. Moreover, I submitted a detailed evaluation from a vocational expert (“VE”), even though none was required.
Submitting all the medical and vocational evidence quickly eliminated many things the insurance company typically does. There was no time for surveillance. Their in house medical staff would have to explain why three medical opinions were all wrong. Had their only been one APS, then the insurer certainly would have been likely to concoct an excuse for rejecting the sole opinion. Alternatively, when the medical evidence is strong, insurers frequently rely on a VE to come up with a reason why the claimant can work. However, that tactic would effectively preempted by the VE report I submitted.
Disability insurers frequently behave like burglars in that they seek the path of least resistance. If a burglar comes across two homes, and one has a big dog, they are likely to move on to the other house. The disability insurer’s goal is to deny or terminate as many claims as possible because that increases their profitability. If a claim looks strong from the outset, then the insurer will move on to the next claim.Previous Next
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