 Below are a list of frequently asked questions also referred to as FAQs. If you do not find the answer to your question here, please give us a call. The South Florida individual disability insurance lawyers at Wagar Law, P.A. will be happy to respond to your disability insurance questions.
Frequently Asked Questions
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1. Is it necessary that I have help when filing my claim for disability insurance benefits?
While it is not necessary that you have an attorney help you file your claim for disability insurance benefits, it is a really good idea. Insurance companies usually make the process of filing for your disability benefits difficult and time consuming. This is on purpose. A certain number of claimants may simply give up trying. If and when that happens, the insurance company does not have to pay out those claims. It is a business strategy used to save the insurance provider money, but as we have seen, can have a devastating affect on the claimant. Knowing this at the onset will benefit you. Your insurance company will ask you for all kinds of information, documents, exams, medical records and so on. If you miss a deadline or fail to provide the information they request, your disability insurance benefits may be delayed or denied. Having an experienced lawyer help you from the beginning will certainly keep your insurance company on their toes.
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2. How long does it usually take for the insurance company to make a decision regarding my claim?
That's hard to say because each situation is unique. From our experience, insurance companies rarely make claim decisions quickly. It benefits them to take their time and drag out the process. That way the money stays in their bank account longer and may even earn interest. Do not be surprised or personally offended by this stall and delay tactic as it is quite common. Florida insurance law requires that companies provide the claimant with a notice of their decision within a reasonable period of time. But what is considered reasonable? Some claims may take months before the insurance company returns with a decision. The experienced disability lawyers at the Wagar Law firm can help you manage your claim and or appeals process. Call us today to learn if we can help you.
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3. The insurance company denied my claim for disability benefits. Am I required to file an appeal?
You are not required to file an appeal. If you fail to do so however, you will most certainly loose your disability benefits and maybe even the right to any future benefits. Having disability benefits denied is common even when the claim is valid. If you decide you want to sue your insurance company it is important to remember, under the terms and conditions of your policy, you may be required to exhaust all appeals prior to litigation.
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4. Since my disability insurance policy covers my “own occupation,” am I prevented from working in another occupation or risk losing my disability benefits if I do?
Your insurance company can not prevent you from working. They may be required to continue paying your disability income benefits so long as your new occupation is different than your prior occupation. If you are doing basically the same type of work, then the insurance company may be able to stop paying your benefits. Insurance companies look for every possible loophole and your new occupation can be a great target. Your disability insurance policy should state your disability is from your own (prior) occupation and not be modified to the broader definition of “any" occupation. If this occurs, your insurance will more than likely terminate your benefits should they become aware that you are engaged in any other employment. A qualified disability lawyer can help you sort out these issues.
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5. The insurance company wants to send me to an independent medical examination (IME). Do I have to go?
Many disability policies have a provision that allows the insurer the right to have you examined by a physician. If your policy has such a provision, then they arguably have the right to have you examined. Insurance companies may over reach by asking you to submit to a functional capacity evaluation or FCE. Your insurance policy may only allow for an independent medical exam but your insurance company may try to send you for the FCE. Keep in mind, you may be entitled to refuse to submit to these exams in certain situations (e.g. where the test or examination may be painful or harmful to the person taking the test or exam).
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6. Do I have to submit to an interview with the insurance company's representative. They want to conduct an interview in person; is that OK?
To accurately answer this question, we will need to carefully review your insurance policy. It is common for insurance companies to use field representatives to collect extensive and personal information from claimants. Usually, these meetings occur without an attorney being present which often benefits the insurance company. Insurance companies like to collect information this way because they know they will probably be able to document inconsistencies in the claimant's statements. Why is that important? Not surprising, they use this information to their advantage to delay or deny paying claims for insurance benefits.
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