We often get this question from people who are off work due to an injury or illness and the insurance company is taking a long time to decide whether the application for benefits ought to be accepted.
To start, make sure that you complete the form within the time required under the policy; that the form is completed properly; and, if the insurer asks for additional information, obtain that information as soon as possible.
While most insurers do not deliberately delay the process, we have heard from frustrated callers complaining that the insurance company’s agents ask for information that has already been provided, do not return phone calls, and request answers to questions that have nothing to do with the claim.
The initial decision should only take a few weeks but we have seen this initial period drag on for many, many months. In circumstances where the insurance company denies the claim, the process takes even longer as claimants attempt to appeal the decision, sometimes through multiple rounds of appeal. During this timeframe, the disabled employee is without income, getting behind financially and under added stress in dealing with the insurance company. Even more concerning, your time to take legal action continues to tick away during this entire time. This means that if your latest appeal is denied after the limitation period to sue has run out, you will likely be barred from taking legal action against the insurance company.
If your claim has been denied and the insurance company invites you to appeal, it is time to call a disability lawyer. When a disability claim is denied, we can help you decide whether it makes sense to pursue the appeal or look at your legal options.