Our Insurance Appeals Lawyer Can Help If Your Claim Has Been Denied
Long-term disability insurance coverage is supposed to protect you if you become disabled and can no longer work due to an injury or serious medical condition. However, the insurance company is a business whose goal may be to save money by denying your claim. Insurance companies deny these claims for a variety of reasons. If you receive a denial letter after you file your claim, you need to remember that the reasons the insurance company denies your claim may not be valid. Our insurance appeals lawyers can review your case and file an appeal on your behalf if the insurance company is making excuses for not paying you.
Why Your Missouri or Illinois Disability Insurance Claim Could Be Denied
Here are the leading reasons we find that long-term disability claims are denied:
- Untimely claim. Your disability insurance policy may give you a deadline after you can no longer work to file a claim. If you miss this deadline or what the insurance adjuster claims is the deadline, your claim may be denied. However, our attorneys may be able to present evidence to prove that you didn't realize you couldn't return to work until a later date and filed your claim in a timely fashion.
- Insufficient claim documentation. Another reason the insurance adjuster could deny your claim is that you don't provide adequate medical or wage loss documentation to support it. We can help you collect additional documents or argue that the insurance company's requests are unreasonable to fight the denial.
- Preexisting condition. Your policy may exclude preexisting conditions. Our legal team will review your policy and medical conditions carefully and, if possible, file an appeal to establish that this policy provision doesn't apply to your situation.
- Lack of disability. The insurance company could argue that your medical condition does not meet the policy's definition of disability or that you aren't disabled because you can do other work. Our insurance appeals lawyers may be able to provide additional medical records, a statement from your physician, and expert witness testimony to refute this.
- Adverse information. The insurance company could spy on you, search your social media sites, or talk to your neighbors and friends to try to dig up damaging information they can use to argue you are not as disabled as you claim. We can guide you on how to protect yourself and have strategies to defeat the insurance company's unfair denial of your claim.
Top Reasons Accidental Death Insurance Claims Are Denied in Missouri and Illinois
If your family member purchased an accidental death insurance policy, you could be entitled to benefits if they died due to an accident, such as a car, truck, or premises liability accident. This policy is not the same as life insurance and would not provide coverage if your loved one died of natural causes.
As with long-term disability claims, insurance companies often deny accidental death insurance claims even when a beneficiary is entitled to benefits. Your claim could be denied for one of these common reasons:
- Not an accident. The insurance company could argue that your loved one's death was not caused by an accident. They may deny your claim for this reason if your family member had a preexisting condition or had a medical condition, such as a heart attack or stroke, during the accident. Our insurance appeals lawyers can examine the medical documentation and help you present evidence that the accident was the true cause of your loved one's death.
- Exclusions. Accidental death insurance policies contain exclusions when an insured's death would not be covered. Common exclusions from coverage include deaths caused by suicide, intoxication, drug abuse, or criminal activities. Our attorneys will review the insurance policy and denial letter and give you an honest evaluation of whether your claim's denial is valid.
- Medical care. The insurance company could argue that your loved one's death was caused by their medical treatment or the lack of proper medical care and not the accident. They may raise this argument if your family member did not die immediately after or within a short time after the accident. We can use your family member’s medical records and expert witness testimony to disprove these arguments.
- Insured's negligence. The insurance adjuster could blame your loved one for their death, arguing that their negligence or reckless behaviors caused it and invalidated their policy. Our lawyers have strategies to fight this and other tactics the insurance company may employ to deny your claim unfairly.
What Should You Do If Your Accidental Death or Disability Insurance Claim Is Denied?
If your claim for long-term disability or accidental death benefits is denied, you must take steps to protect your rights. Here are crucial steps our St. Louis insurance appeals lawyers recommend you take:
#1: Read Your Policy and the Denial Letter
You should read the insurance policy and denial letter carefully to try to understand why the insurance company denied your claim.
#2: Gather Evidence
You should collect and preserve any evidence you have. This can include police or incident reports, death certificates, and medical records that support your claim.
#3: Meet Deadlines
Your insurance policy may give you a short deadline to file an appeal of their denial of your claim. You must meet these time limits, or you may not be able to pursue your appeal.
#4: Retain an Attorney
One of the most critical steps you need to take is to hire an insurance appeals lawyer at Bollwerk & Associates, LLC as soon as possible after your claim is denied. We will review your insurance policy and denial letter and explain your options in language you can understand. We will also collect the evidence you need to build a strong case and file your appeal on a timely basis to fight the unfair denial of the benefits you should receive under the insurance policy.
