If you are unable to work due to a disabling accident, injury, or illness, managing your medical care and treatment is likely consuming much of your time and energy. Navigating the complexities of insurance claims can add unnecessary stress during an already challenging period.
Our Sacramento long-term disability (LTD) claims lawyers understand the intricacies of LTD claims in Sacramento. We are here to guide you through the process, ensuring you receive the crucial benefits you deserve.
Whether you are trying to file an initial claim, challenge a denial, or seek representation in court, our attorneys will advocate for you. With years of experience and an understanding of long-term disability, we have successfully helped countless individuals in Sacramento secure the benefits they deserve.
When you choose Kantor & Kantor, you choose a partner who will fight for your rights and ensure your voice is heard. Contact our Sacramento LTD claims attorney at 818-886-2525 for a free consultation.
We offer a free case consultation to discuss how our attorneys can assist you. Contact us now at 818-886-2525 for a free consultation.
What Is Long-Term Disability Insurance?
Long-term disability (LTD) insurance is a type of coverage designed to provide financial protection to people who become unable to work for an extended period of time 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.
These benefits can cover a significant portion of your income, ensuring you and your family are supported during challenging times. However, obtaining these benefits is rarely as easy as it should be.
Common Tactics Used by Insurance Companies to Deny LTD Claims
Here are some common tactics used by insurance companies:
1. 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.
2. Surveillance
Insurers may conduct surveillance on claimants in an attempt 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 as a whole.
3. Independent Medical Examinations (IMEs)
Insurance companies often require claimants to undergo IMEs by their chosen physicians. These exams may be biased towards the insurer’s interests, resulting in assessments that underestimate the severity of your condition or deem you fit for work prematurely.
4. Allegations of Malingering or Exaggeration
Insurance companies may accuse claimants of malingering or 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.
5. 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.
6. 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 being primarily physical.
Common Reasons for LTD Claim Denials
Insurance companies often deny LTD claims for various reasons, including:
1. 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.
2. Pre-existing Conditions
Insurance policies often 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.
3. Policy Exclusions
Long-term disability policies may exclude certain conditions or injuries from coverage. Common exclusions include mental health conditions, self-inflicted injuries, or conditions resulting from substance abuse.
4. Administrative Errors
Clerical or administrative errors, such as missing information, incorrect forms, or missed deadlines, can result in claim denials. Even small mistakes can lead to a denial.
5. Lack of Objective Evidence
Insurance companies prefer objective evidence, such as test results and imaging studies, to support a disability claim. They may deny claims that rely heavily on subjective reports of pain or other symptoms.
6. 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.
7. Ignoring or Misrepresenting Medical Advice
Insurers may ignore or misrepresent medical opinions and recommendations from healthcare providers to support their decision to deny benefits.
8. 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.
9. 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.
We are people helping people, and we are ready to help you with your LTD insurance case.
What Should I Do if My LTD Claims Have Been Denied?
If your LTD claim has been denied, taking prompt and strategic steps to protect your rights and potentially overturn the denial is crucial. Here is what you should do:
1. Review the Denial Letter
Carefully examine the denial letter to understand why they denied your claim. This document will outline specific details and factors they considered in their decision.
2. Gather Supporting Documentation
Collect all relevant medical records, doctor’s reports, test results, and other evidence supporting your disability claim. Comprehensive documentation is essential to substantiate the seriousness of your condition and its impact on your ability to work.
3. Understand Your Appeal Options
Insurance policies typically provide a limited time frame to appeal a denial. Familiarize yourself with these deadlines and procedural requirements to ensure you file your appeal on time.
4. Seek Legal Guidance
Consulting our experienced Sacramento LTD lawyer can be invaluable at this stage. Our disability insurance lawyer can assess the strength of your case and advocate on your behalf during the appeals process.
Why Choose Kantor & Kantor to Represent You?
We understand the complexities of dealing with insurance companies and the disability law. Here is why our clients trust us:
- Experience That Matters: With years of dedicated service in disability law, we bring a depth of experience that few firms can match. Our Sacramento LTD lawyers have successfully handled numerous cases, from initial claims to complex appeals, achieving favorable outcomes for our clients.
- Proven Track Record: We have helped countless individuals like you secure the benefits they deserve. Whether through negotiation, mediation, or litigation, we are relentless advocates for our clients’ rights.
- Client-Centered Approach: At Kantor & Kantor, our clients come first. We prioritize clear communication, transparency, and integrity in everything we do. You can trust that we will always act in your best interests and keep you informed at every step of your case.
- Results-Oriented Representation: Our ultimate goal is to deliver results. Whether negotiating with insurers or presenting your case in court, we pursue your benefits. We are not afraid to challenge unjust denials and fight on your behalf.
How We Can Help with Your LTD Case
At Kantor & Kantor, we understand the frustration and uncertainty you may be experiencing. That is why we are here to provide you with legal guidance every step of the way. Here is how we can help:
Thorough Evaluation of Your Case
Our experienced Sacramento 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.
Talk to Our Sacramento LTD Claims Attorney Today
If you are facing challenges with your LTD claim, we are here to help. We understand the complexities of LTD law and are here to help you navigate this difficult time.
Contact us at 818-886-2525 to schedule a free consultation. Let us guide you through your options and work together to resolve your LTD claim successfully.