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Disability denials

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  • Disability denials

    I am wondering if anyone has or is aware of anyone being denied a disability claim and the whys of the situation. The heart of my question is concern over the large investment in a policy that may result in a denied claim. Thank you

  • #2
    We really have not run into many claim denials at all.  Most the time the issues with claim denials happen when language in your policy is sub-par.  When you use one of the high quality contracts (Big 6) that are specifically built to be the best in class then the language that causes most claimants their heartburn is not present.  As an example I was reviewing a clients AMA policy last week for them and that client was unaware of the "Total and Continuous" clause in their elimination period verbiage.  What that meant is the client needed to be Totally (not 50%, 70%, or even 90% disabled but 100%) disabled for a continuous 180 days (that does not mean out for 160 days, try to come back to work and decide your not ready then the next day is 161, no now it is day 1 again).  At claim time that individual will say "the carrier found a loop hole".  The carrier did not find a loop hole rather the language was there just nobody read it, explained it, or asked about it.

    Feel free to email or call me, happy to give you my opinion about your personal situation.

    Scott Nelson-Archer, CLU, ChFC
    281-770-8080 Direct / [email protected]


    • #3

      Claim data in any meaningful form really doesn’t exist.

      You should focus on contract wording bc that’s your best defense.
      Click to expand...

      And eliminating the need for the policy as soon as possible!

      Can't be denied a claim for a policy you don't have or need! One less risk (and premium) to worry about!
      Helping those who wear the white coat get a fair shake on Wall Street since 2011


      • #4
        Thank you all for your responses, this helps


        • #5
          I've known a few people denied disability claims, all dentists. The insurance company just needs a picture of you opening your car door to claim you have enough dexterity to perform your duties.

          The only person I know actually receiving his benefits has a problem with his eyes.