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Facing a serious illness or injury that leaves you unable to work is a life-changing experience. Beyond the physical and emotional challenges, the financial strain can quickly become overwhelming. That is where long-term disability (LTD) insurance should step in to provide support, helping you stay financially stable while you recover. Unfortunately, getting LTD benefits isn’t always easy.
During these difficult times, LTD insurance is “designed” to provide the support you need to maintain financial stability. Unfortunately, accessing LTD benefits can be an uphill battle when you are dealing with insurance companies.
Insurance companies actively look for ways to deny valid claims, using complex procedures, ambiguous policy language, and outright deceit to reduce payouts. When your claim is unjustly denied, it is critical to have experienced legal representation on your side to fight back. At Kantor & Kantor, our Orange County LTD attorneys are dedicated to helping clients navigate these challenges, utilizing our deep knowledge of LTD claims to overturn denials and secure the benefits you deserve.
What Is Long-Term Disability Insurance?
Long-term disability (LTD) insurance is a type of coverage designed to provide financial protection to people who have become unable to work for an extended period due to an injury or illness. Unlike short-term disability insurance, which typically covers disabilities lasting up to six months, LTD insurance is intended to replace a portion of your income for an extended period.
In theory, it sounds straightforward. But getting these benefits can be an frustrating experience. Insurance companies often look for reasons to deny claims, leaving you struggling to make ends meet.
Common Tactics Used by Insurance Companies to Deny LTD Claims
Insurance companies are notorious for using a variety of tactics to avoid paying LTD claims. Here are some of the most common ones:
Selective Review of Medical Evidence
Insurance companies may selectively review medical records to downplay the severity of your condition or overlook crucial evidence supporting your disability. They may focus on minor details while disregarding the overall impact of your impairment.
Surveillance
Insurers may conduct surveillance on claimants to discredit their disability. They may hire private investigators to monitor your activities, looking for any evidence that contradicts your claimed limitations. Even if they do not observe you contradicting your stated abilities, they may try to portray whatever they do observe as somehow in conflict with your credibility.
Independent Medical Examinations (IMEs)
Insurance companies often require claimants to undergo IMEs by their chosen physicians. These exams may be biased toward the insurer’s interests, resulting in assessments that underestimate the severity of your condition or prematurely deem you fit for work.
Allegations of Malingering or Exaggeration
Insurance companies may accuse claimants of exaggerating their symptoms to prolong disability benefits unlawfully. They may use inconsistencies in medical records or subjective assessments to cast doubt on the legitimacy of your claim.
Policy Interpretation
Insurers may interpret policy language to favor the denial of benefits. They may exploit ambiguous terms or exclusions in the policy to justify their decision, even if it contradicts the original intent of the coverage.
Limiting Benefits
Most policies have limitations for mental health disabilities, capping the amount payable to two years of benefits. Insurers may try to classify your claim as primarily based on mental health issues despite your disability’s being primarily physical.
Common Reasons for LTD Claim Denials
Insurance companies often deny LTD claims for the following reasons:
Insufficient Medical Evidence
One of the most common reasons for denial is inadequate medical documentation to substantiate the disability. Insurance companies require comprehensive, ongoing medical records demonstrating your condition’s severity and duration. They may argue that the evidence provided does not sufficiently prove that you cannot perform your job duties.
Pre-Existing Conditions
Many insurance policies have exclusions for pre-existing conditions. If the insurance company determines that your disability is related to a condition that existed before your coverage began, they may deny your claim.
Policy Exclusions
Long-term disability policies may exclude certain conditions or injuries from coverage. For example, many policies will not cover disabilities related to mental health conditions or substance abuse, and others might exclude certain types of injuries.
Administrative Errors
Even small mistakes—like missing a deadline or submitting the wrong form—can lead to a denial. It is frustrating, but even minor errors can make a big difference in how your claim is processed.
Lack of Objective Evidence
Insurance companies prefer objective evidence, such as test results and imaging studies, to support a disability claim. If your disability relies mostly on subjective symptoms like pain or fatigue, insurers may question the legitimacy of your condition.
Retaliatory Actions Against Claimants
In some cases, insurers may retaliate against claimants or their legal representatives for challenging claim denials or filing complaints, such as increasing premiums or threatening to cancel other insurance policies.
Ignoring or Misrepresenting Medical Advice
Insurers may ignore or misrepresent medical opinions and recommendations from healthcare providers to support their decision to deny benefits.
Lack of Transparency
Insurers may fail to provide clear explanations for claim denials, or the criteria used to assess disability, making it difficult for claimants to understand the reasons for the decision.
Unfair Surveillance or Investigation Tactics
Insurance companies may engage in invasive surveillance or investigation tactics, such as covert surveillance or social media monitoring, to discredit claimants’ disability claims.
Our attorneys at Kantor & Kantor will help you gather all medical records and other documentation.
Why Choose Kantor & Kantor?
When it comes to fighting insurance companies, experience matters. At Kantor & Kantor, we have decades of experience handling LTD claims. We understand the games that insurance companies play and know how to counter them. Here is why you should choose us:
Experience and Expertise: With decades of collective experience in handling LTD claims, our team has the knowledge and skills to navigate even the most complex cases. We have successfully represented countless clients, securing the benefits they deserve.
History of Achievements: We have a strong track record of success in securing benefits for our clients. Our firm has helped numerous individuals obtain the compensation they deserve, even in the face of denial or resistance from insurance companies.
Zealous Advocacy: When it comes to advocating for our clients, we do not back down. Our attorneys are known for their tenacity and determination in fighting for our client’s rights. We will go to great lengths to ensure that you receive the full benefits you are entitled to under your policy.
Compassionate Support: Dealing with a long-term disability can be emotionally and financially draining. We are here to provide more than just legal representation—we are here to support you every step of the way. We are here to answer your questions, address your concerns, and provide guidance and reassurance during this challenging time.
Client-Centered Approach: At Kantor & Kantor, you are more than just a case number – you are a valued client and partner in the legal process. We prioritize your needs and objectives to achieve the best possible result for you and your family.
Our experienced Orange County LTD attorneys have the knowledge and experience to hold insurers accountable for their actions and pursue the full and fair compensation our clients deserve.
How We Can Help with Your LTD Case
At Kantor & Kantor, we understand your difficulties in obtaining the benefits you deserve. Here is how we can help:
Thorough Evaluation of Your Case
Our experienced Orange County LTD lawyers will thoroughly evaluate your case to determine the strength of your claim. We will review your insurance policy, medical records, and other relevant documentation to assess your eligibility for benefits.
Strategic Claim Preparation and Submission
Preparing and submitting an LTD claim requires attention to detail and thorough documentation. We will assist you in gathering the necessary evidence and completing the required paperwork to ensure your claim is submitted accurately and on time.
Claim Denial Appeals
If your claim is denied, we will not hesitate to challenge the decision through appeals. Our attorneys have extensive experience in handling claim denial appeals. We will thoroughly review the denial letter, identify the reasons for denial, and develop a strong appeal strategy. Whether it involves providing additional evidence, challenging the insurer’s decision, or filing a lawsuit, we will do whatever it takes to fight for the benefits you deserve.
Litigation Support
In some cases, litigation may be necessary to secure the benefits you deserve. If negotiations with the insurance company are unsuccessful, we are prepared to take your case to court and present a compelling argument on your behalf.
Contact Our Orange County LTD Lawyers Today
Do not allow insurance companies to prevent you from receiving the financial support you need during a time of hardship. At Kantor & Kantor, we fight relentlessly to ensure our clients get the benefits they are owed.
If you are struggling with a denied LTD claim, contact us today at 818-886-2525 for a free consultation. We take pride in being people helping people, and we look forward to helping you.
Attorney Glenn R. Kantor
Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]
