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How do I file a disability insurance claim?

Daniel Walker
Licensed Insurance Agent for 15 Years

UPDATED: Mar 19, 2020

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How Do I File A Disability ClaimIn order to file a disability insurance claim you will need to obtain the needed documents, visit a doctor, and turn in the appropriate paperwork signed by the right people. By filing the claim properly, you increase your chances of receiving your needed benefits.

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Disability insurance is a type of insurance that is there for you in those emergency occurrences when you find that you are unable to work.

This may be due to an injury, illness or anything else that would leave you in a disabled state. It usually applies to both short term and long-term disability types, and such a policy ensures that income keeps coming in even if you are unable to find a job.

So you decided to purchase this policy, have paid your premiums on time, and unfortunately, you now need disability coverage.

Where do I start to file my claim?

You should start by rereading all the fine print of the terms and conditions in your policy before making any initial calls. Make sure you understand what is required for filing, what a disability is  based on your personal policy requirements, and what documentation is needed.

Many questions will be asked by the insurance company such as:

  • Did the disability result from an illness that was previously known before the coverage began, or was it an unpredictable event?
  • Is the insured completely disabled or only partially disabled?
  • How long will the payments continue and will they be paid weekly or monthly?
  • If you have been unable to work for the time period stated in your policy then you can then start regular disability income.

Before you fill out any paper work from the insurance company, you will need to visit your primary doctor for a thorough examine. Most cases will depend on provided forms filled out and signed by a doctor stating the cause and establishment of the disability, along with any test results that are applicable.

Make sure that you keep all documents together and write down any important notes, dates and times in case further questions arise. You will then contact the insurance company to get their claim forms. These are sometimes available online.

Along with these forms, you will attach the original copy of your primary physician’s letter and any other supporting documents. Do make sure that you make photocopies of every form you are sending in to keep for your own records.

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What is the best advice for filing?

Be sure to fill out all claim forms accurately, honestly, and fully. If you have any questions, be sure to ask your insurance agent before sending in the required forms. Once your information is received, you may need to go through a personal interview. Don’t get stressed about this step; it is usually just to get a little more information and fill in any gaps that the forms you sent in may have.

Now comes the hard part: the waiting. It is best if you keep up with your claim, speaking to your adjuster often, or follow your claim online if that option is available. You will then receive a letter stating that your claim for disability was either denied or accepted. Most cases flow smoothly if you have the proper documentation from your doctor and all forms on the application are filled out correctly.

If for some reason you are denied, don’t panic. Read the explanation given from the letter. If more documentation or proof is required, you will be advised on what is needed. If, for some reason, you are denied and it seems truly unreasonable, then you can contact a lawyer for legal assistance in resubmitting your claim. Remember to keep every copy of correspondence and write down names and times with everyone you speak to.

Why are disability claims sometimes denied?

The top reasons your claim may be denied are if you do not meet the policy’s definition of disability, or because of pre-existing conditions , or if there is not enough evidence on the initial claim forms. These things can usually be avoided by reading your policy thoroughly, getting doctor’s letters, and carefully filling out all claim forms.

Do expect some wait time in filing and receiving benefits. It can take up to 15 days or more, though most companies process these types of claims in under two weeks time. Make sure you understand your policy completely and know what you are entitled to. If you have gone with a trustworthy insurance company, then you are in safe hands. However, there are always those less then scrupulous insurance providers out there. Knowing what is coming to you will save you from getting cheated out of anything you deserve.

The process may seem a little scary at first, but once you send in the forms and speak to your insurance agent, you will see how easily everything flows and you will be happy to have this type of insurance policy. Going through a hardship, especially one involving a disability, can be scary. Disability insurance can help make the situation more manageable and less stressful.

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