how to appeal denied insuranceWhen a large insurance company like Unum denies your long-term disability (LTD) claim, you may feel powerless. Large corporations like Unum have a way of making their determinations feel final.

However, it is important to remember that regardless of the situation, you still have rights. Most insurance companies have an internal appeals process, which must be exhausted before seeking legal solutions. If you feel your LTD claim is denied wrongly, you must take several steps to appeal your case.

Here are five ways to help you appeal a denied insurance claim:

Gather Information

First, you need to get several critical pieces of information. Most importantly, you need to make sure you’re aware of every deadline. Many internal rules, as well as legal remedies, have a rigid timeline that you must work within. But these deadlines aren’t the only type of information you need to proceed. You must also procure as much information about the denial. Collect all information from the denied claim, and press the company for additional information. Some critical questions include:

  • Which specific policy clauses led to the long term disability claim denial?
  • What occupation does the company believe you can perform?
  • What job description are they using?
  • What documentation or proof do they feel is lacking? What do they need?

Follow Procedure

You need to keep a cool head and continue to follow the rules. Document every contact you have with your insurance company, in case you take legal action later. Never let anger of frustration determine your actions. While the situation may be frustrating or threatening, acting out of anger can make things much worse. Remember that every communication you have with the insurance company is an effort to obtain information, and remain true to this ultimate mission.

Documentation

After you know the reasons behind your long term disability claim denial, you need to get information that will fill the gaps. For example, if they need more medical documentation, you should start keeping a journal  of your symptoms, and get a detailed letter from your doctor explaining your illness and symptoms. You can even ask family members to write up statements of how your symptoms have affected your daily life. Since most LTD claims involve the inability to work, ask your last employer for a statement regarding how your illness has affected your work. In all of these statements, you must remember that the devil is in the details. Specifically, you must make sure your statement captures as much detail as possible.

File Your Appeal

Once you’ve amassed all of your documentation, write an appeal letter. Make sure it’s in compliance with any format the insurance company needs. First, write up an overview of the situation, explaining how the evidence shows that you are disabled per the policy’s terms. Again, keep a cool head and do not make any insulting or attacking comments. You must also avoid threats. Just CCing the document to your attorney and your state’s insurance commissioner is sufficient to show your resolve. Once you’ve sent them your appeal, wait a few weeks, then call and make sure the materials have been received. You may have to go through the appeals process more than once.

Consider Legal Action

If your appeals are denied—and many insurers have a set number of appeals—you may need to seek legal action. Many lawsuits have been filed against companies like Unum, seeking the reinstatement of insurance benefits.

If you’ve had a legitimate insurance claim denied, you may feel frustrated and overwhelmed. But you need to remember that you still have rights, and there are steps that you can take to regain a measure of control over your situation. You can start by visiting the Disability Insurance Claim Denial Class Action Lawsuit Investigation. Here, you can enter information about your situation for a free legal review by a trained expert with a background in this type of litigation.

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