An Introduction to Disability Insurance Claim:
Disability insurance claim can be simple or difficult depending upon the extent of damage. Almost 86% of the
disability insurance claims are caused by
illness. Almost all private
employee benefit
plans are regulated and enforced under the law by
Employee Retirement Income Security Act (ERISA) of 1974.
Claims arising from
group plans or
employer provided
disability plans are governed by
ERISA whereas
State Law is applied for settling
claims in private
individual disability plans.
Asking for disability insurance claim:
Disability is a
physical or
mental impairment(temporary or
permanent) that prevents one from working efficiently in the particular occupation he is involved. There are three different definitions of
disability:
Own Occupation- The person is unable to perform the important duties related to his own occupation.
Modified Own occupation- The person is unable to perform the important duties and on top of that he is refraining from his work.
Any Occupation- This disability renders the person unsuitable for any occupation where otherwise the person may find worth according to his education and experience.
The HIAA Source Book of Health Insurance depicts 'back problems' as the major reason for asserting disability insurance claim. Surprisingly the second major reason for claiming benefit is psychiatric and emotional disorders. This might occur because one saw his 10 year old child going through chemotherapy or due to a tense situation at office or home. A claim depends on the type of coverage on has bought. Another factor is the type of disability i.e. whether the disability is partial, full or residual. One just has to complete a form and return it to the insurance company. One portion of these form is to be filled by the physician treating the disabled. In case of a group plan an employer also has certain obligations. The claim must be substituted within a specified period of time(30 days) of being disabled. In case of short term disability insurance plans one must be disabled for at least 8 consecutive days and must either be employed or seeking job in an active manner.
Points To Remember Before Filing Disability Insurance Claim:
First things first. One must understand the precise definition of disability in his policy to determine whether his condition qualifies for benefits.
Most disability policies require one to be under the care of a doctor. So it is mandatory that the doctor treating the disabled confirms and explains the problem in writing .
The answers given in the disability insurance claim form must be true to the maximum extent. An unsure question must be marked unsure. In case an answer contradicts the medical record that the insurer will obtain, the insured must have a comprehensive explanation for that.
Almost all disability policies incorporate an elimination period. An elimination period is the period of time one remains disabled before receiving benefits. So one must arrange for enough money to meet usual expenses.
A disability insurance claim must be filed as soon as one discovers his disability. A failure to do so can lead to the insurance provider denying the claim.
Under no circumstances should the insured give up his rights. An offer to compromise by accepting less can lead to worse consequences.
Under an own occupation policy, one can collect benefits if he can no more continue his own job but can get employed in another kind of job.
Insurance companies can videotape a person who has filed a disability insurance claim to record him doing something that he claims he is unable to do.
One must not keep any stone unturned in understanding the policy and disability insurance claims. So he must not bother asking questions that look stupid.
For further information one may view sites like edd.ca.gov, metlife.com,
unitedpolicyholders.org