Across the country, millions of Americans are forced to undergo the tedious process of filing a long-term disability (LTD) insurance claim to their insurance provider, only to find their insurance claim denied. With this being such a common occurrence among big name insurers like Unum, legal experts are providing free advice and tips on how to fight against insurance claim denials so policyholders can receive the coverage they deserve.

The first thing experts advise claimants is not to be surprised by a rejection, as many insurance claim denial appeals end in success. However, to increase the chances of getting the insurance claim approved, there are several steps a consumer can take to increase the likelihood of an approval:

• Obtain a Copy of Insurance Policy: For those who have not already done so, obtaining a copy of their LTD policy that includes a summary plan description can be very helpful. Claimants should be able to get this from their employer’s  human resource department or their insurance company. If the human resources department or insurance company fails to provide the copy, the claimant can request them in writing from the insurance plan administrator, who is legally required to provide them under the federal policy, ERISA. These documents should be sent through certified mail with return receipt requested.
• Analyze Denial Letter: The claimant should review the insurance claim denial letter and note the reasons for why the claim was denied or any other information that may be applicable to to approve the claim later on. The insurance claim denial letter should explain how to file an appeal and explain the deadline of the appeal process. Missing the appeal deadline is the quickest way to hinder success for the claim.
• Consider Legal Action: If the claimant is considering legal action, they should hire a lawyer as soon as possible. The lawyer will work with the claimant in putting their case in the best light possible, often by obtaining medical evidence.
• Collect Missing Records: Unfortunately, it is common that insurance companies do not obtain all relevant medical records for the insurance claim, so obtaining any possible relevant records will help.
• Conduct Relevant Medical Tests: In denied insurance claims, insurance providers often point out lack of objective evidence for the consumer’s claim. Experts advise claimants to contact their claims representative inquire what medical tests would be needed.
• Request Letters or Expert Testimony: Written testimony from friends and family members citing the claimant’s limitations from their injury will help the credibility of the insurance claim denial appeal. Testimony from vocational experts that are in a similar industry as the claimant can vouch for how debilitating the injury would be in the claimant’s work field. It is important for the claimant and their witnesses to remain as honest as possible in the disability questionnaire and any other paperwork they fill out. Any exaggerations or lies could justify a claim denial.
• Request Written Opinions from Doctors: Collecting written opinions from medical experts regarding the claimant’s condition is among one of the most important steps in the legal process. This testimony is crucial when trying to prove the validity of the long-term disability benefits claim, the most crucial element of the claim appeal process. Even though doctors tend to charge a small sum for this service, it is well worth the investment. If a doctor is not willing to help with this process, legal experts advise for the claimant to switch doctors.

While many insurance companies have been accused of dismissing long-term disability claims for insufficient reasons, Unum Life Insurance Company is one of the most infamous for these alleged actions. Well known for its frequent insurance claim denials, its policyholders often find themselves at the mercy of the claim approval or denial process, often having to appeal the claim only to get rejected once again at a later date. It is important to note that not all policyholders get rejected, but Unum and other insurance companies have recently garnered a nasty reputation for responding to the claimants with bad news.

Some insurance companies will still deny the claim even after an effective appeal process, in which case further legal action may be needed in the form of a bad faith insurance lawsuit.