You buy short term disability and long term disability insurance in order to protect yourself and your family. In many cases, the insurance company denies the disability claim from the beginning. Other times, the disability insurer approves a claim only to terminate benefits later. As a lawyer for the disabled, I help people with claims that are denied at the outset as well as claims where the insurance company initially approves the insurance benefits and later terminates the benefits.
What do you do if you have been approved for short term disability or long term disability benefits only to later have the insurance company terminate those benefits?
Once an insurance company approves disability benefits it can only terminate those benefits if it can show that there has been a "substantial change in condition." The burden of proof is on the insurer to demonstrate that change in condition. Often, however, the insurance company will write letters to the insured advising that it is terminating benefits because the insured has failed to demonstrate that he or she continues to be disabled. The insurance company wants the insured to feel like the burden of proof is on them to demonstrate that the are disabled. While the insured must cooperate with the insurance company’s investigation, the insured does not have to prove continued disability. To the contrary, the insurance company must prove a substantial change in condition which warrants termination of benefits.
Sometimes, the disability policy’s definition of "disabled" changes after a certain amount of time. For instances, some disability insurance policies state that they will pay disability benefits during the first two years if the insured is disabled from their "own occupation." After two years, the insurance policy requires that the insured be disabled from "any occupation." In many of those cases, the insurance company terminates benefits once the own occupation period expires. In this instance, the burden of proof remains with the insured, but there are still many ways to prove that the termination of insurance benefits was improper.
The bottom line, is if your short term disability carrier, or long term disability carrier denies or terminates your disability insurance you have options. Frankly, every disability insurance case I’ve ever won has one thing in common – every one of them started with a denial.
In all of the disability insurance cases I handle, the initial consultation is always free. And, in most of the disability insurance cases I take, the insurance company has to pay my fees and costs if I win, and if I lose, I’ll work for free.
I also help with appeals if your insurance company has denied your disability claim.