Defending And Empowering The Disabled Since 1993

Why would a professional’s long-term disability application be denied?

On Behalf of | Apr 2, 2023 | Long-Term Disability

Whether you’re a doctor, an accountant, an attorney, a company’s chief executive officer, a business owner or any other kind of highly-placed professional, long-term disability insurance is an essential protection that you need.

In the words of one expert, long-term disability insurance “is a really critical safety-net benefit.” Typically, it pays 50%-60% of your income, perhaps until you hit retirement age. That can help you pay your bills, maintain your standard of living and support your family. The benefits are also often tax-free, which makes them even more valuable – if you can get them.

Long-term disability insurance claims may be denied for a variety of reasons

Policies and insurance companies vary quite a bit, but there’s one thing they all have in common: Actually obtaining your benefits when you need them can be difficult. The application process can be complicated, the timeline for a decision can be murky and benefits can be denied for all kinds of reasons. These include:

  • Failure to meet the definition of disability: Long-term disability insurance policies typically define disability as either the inability to perform the duties of your own occupation or any occupation for which you are reasonably qualified. If the insurer says you do not meet the policy’s definition of disability, your claim will be denied.
  • Insufficient medical evidence: You must provide medical evidence that supports your claim. Sometimes claims are denied because a medical provider never returns a form, or the insurer claims that there are inconsistencies in your records.
  • Pre-existing conditions: Some long-term disability insurance policies exclude coverage for pre-existing conditions or have waiting periods before coverage begins for certain conditions.
  • Administrative errors: Sometimes, long-term disability claims are denied due to administrative errors, such as missing or incomplete paperwork or errors in communication between the insurance company and the claimant.

The reality is that some insurers look for ways to delay, devalue and deny any payment they might have to make – even if you paid your long-term disability insurance premiums faithfully. Professional incomes can be hefty, and insurance companies are reluctant to pay them. If you believe that your long-term disability insurer acted in bad faith, it may be time to learn more about your legal options.


FindLaw Network