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From the time that we are children, we do not react well to denial of something that we want to have. Still, adults have good reason to dispute denial of a deserving benefit. That fact underscores the reason that anyone who has been seriously injured in an accident needs to learn about the proper response to a denial letter from an insurance company.
Reasons for the granting of short-term disability (STD) or long term disability (LTD) benefits
STD benefits provide an employed adult with temporary relief from financial problems, in the event that the same adult gets sick or incapacitated.
LTD benefits cover the needs of an employee that has been receiving STD, but has failed to recover within the stated period of time. The person that applies for LTD benefits is supposed to have a long-term illness, or to have become the victim of a disability.
Two possible courses of action, following the receipt of a denial letter
Check to see if the insurance company sent information on the company’s internal review process, along with the letter. If it is there, study the information you have received. Follow the process, or seek more information, if you remain unclear, regarding some aspect of that review process. Understand that a decision to pursue that review process does not guarantee attainment of a quick solution.
Analyze the company’s actions. How do they match with the company’s promises? If the insurance company fails to act in a manner that matches with what has been promised in its contract, you may have reason to initiate litigation against the insurer.
If you elect to take action against a company that has acted in bad faith, then you will need to seek the assistance of a personal injury attorney. Try to find one that specializes in cases concerning refusal of long-term disability benefits.
Learn what is expected of you. Are you supposed to seek an available treatment, and then keep working for a stated period of time? Some company’s take that approach, and ask the employee to undergo a second test, after receiving the available treatment. If the treatment proves ineffective, the employee should become eligible for the desired benefits.
Some demands on you will not be made until you have carried out a specific task. For instance, you may be asked to attend an independent medical exam (IME). If the insurance company does not like the findings from the doctor that gives you that first exam, then you may get asked to attend a second one, at the office of a different physician. Injury Lawyer in Orillia advice’s that do your best to cooperate with any request. That approach makes it easier to highlight the company’s failures or inadequacies.