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Long-Term Disability Insurers’ History of Wrongfully Denying Claims

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Shawn E. McDermott

LTD insurers continue to wrongfully deny claims. While there has been some exposure of the nature and extent of the tactics used by insurance companies to wrongfully deny disability claims, the practice continues. This is especially the case if the LTD insurance benefit comes from an employer provided source and thus the claim is governed by the Employee Retirement Income Security Act (“ERISA”).

These claim practices of disability insurers have created a process which can be cumbersome to negotiate and difficult to understand. For some carriers, it is fair to characterize their process as merely a system designed for issuing denials. Following a denial, the insurers do not inform the denied claimant about the truth surrounding the mandated internal appeal process. The insurers do not describe the extreme importance of submitting a thorough and timely appeal, and that the claimant will likely be prevented from introducing further evidence in support of his or her claim in court if the internal appeal process is unsuccessful. With such a system in place, long-term disability insurers regularly deny claims by either ignoring the available medical evidence or changing the facts on the claim to “justify” the denial of it.

A Closer Look These Claim Denial Tactics

Some of the tactics employed by LTD insurance carriers to deny valid claims include:

  • Failing to properly investigate claims
  • Failing to properly obtain all relevant medical records
  • Failing to explain the investigation process to the insured
  • Altering the terms of policies after a claim has been filed (i.e., post-claim underwriting)
  • Obtaining biased opinions from third parties who were not qualified to provide those opinions regarding claims or who have a bias in favor of concluding claimants are not disabled
  • Mischaracterizing or misinterpreting medical records from independent medical examiners
  • Issuing claim denials without having any medical exam performed on a claimant
  • Failing to take into account the actual and real occupational duties of a claimant
  • Refusing to acknowledge a claimant’s disability, particularly when that disability involved a mental disorder, or attempting to use claimants’ friends, colleagues, etc. to discredit the disability
  • Terminating a previously approved claim despite the fact the claimant’s condition has not changed or the symptoms have improved
  • Ignoring evidence of the Social Security Administration’s finding of disability under a much more stringent (“any occupation” type) definition, and despite the fact the insurer required the claimant to apply for SSDI.

These are just a few of the issues we see every day in the handling of denied long-term disability insurance claims. If you have experienced these issues with a LTD insurance company, feel free to share your with us on Facebook & Google+. If you require a consultation on a denied claim, you might want to contact us directly.

You Can Trust a Denver Disability Insurance Lawyer at McDermott Law, LLC

Has your disability insurance claim been denied? If so, you can turn to Denver Disability Insurance Lawyer Shawn E. McDermott for help standing up to insurers and obtaining the benefits you likely deserve. Dedicated and experienced, Shawn McDermott and his experienced staff habe a record of success when it comes to helping people:

  • Navigate the complexities of the legal system
  • Fight denied insurance claims
  • Stand up to insurers
  • Secure the full amount of benefits to which they are entitled.

To learn more about how the disability insurance attorneys at McDermott Law, LLC can help you, set up a complimentary consult with our office today by calling us at 303-964-1800 or by emailing us using the contact form on this screen.

From our offices in Denver, we provide the highest quality legal services to disabled people throughout the state of Colorado, the surrounding states and nationwide.

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