Sample Letter To Insurance Company To Pay Claim

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To protect their businesses and their shareholders, disability insurance companies have made it difficult for the average person to file a claim and receive the benefits they signed up for. When someone succeeds in getting benefits on a disability insurance policy, this is long-term and very expensive for companies.

Because of the laws governing disability insurance policies that have been written down, there are no penalties in place when companies reject or delay claims. If you have to fight for your disability benefits and it takes a year, during which time you lose your home and your life savings, there is no penalty or penalty for the disability insurance company. If you win a court case, you will receive what he was supposed to pay you in the first place. The only thing an insurance company loses is its law firm time, while the sick or injured may lose much more. This is why it is important to know as much as possible about disability insurance, the claim process and the process of fighting a claim to protect yourself.

Insurance companies employ many medical professionals to investigate claims. They have a staff of nurses and doctors who do nothing but read medical records and review diagnostic tests throughout the day to build cases against claimants. There are many cases we’ve seen where a medical reviewer sees only a small portion of a person’s medical file – important documents that clearly confirm the presence of a serious illness are excluded. Is this intentional or just bad records management? It’s hard to know – but the bottom line is that disability insurance claimants have to struggle to make sure their full medical records are checked.

Insurance companies often use in-house medical staff to contact treating doctors, review claims, and write imprecise letters to help build cases against claimants. Typical scenario: The medical officer calls the doctor’s office, talks about the plaintiff, and then the insurance company employee sends a letter to the doctor’s office confirming the conversation. The problem is that the message is not completely accurate and does not reflect the conversation that occurred. Some facts are twisted, others are completely neglectful. The important part is this: the message will contain a phrase that says “Unless we receive a response from you by (a certain date), you accept the phrases in the message as true.”

Doctors, office managers and their staff are busy, and answering this message is not their top priority. When no one responds, or when the response comes after the date, the insurance company uses that as an agreement with the contents of the letter, even if the message is completely inaccurate and conflicts with every piece of information in the patient’s medical record.

Today, it is inexpensive for insurance companies to use video surveillance to monitor the activities of claimants. If you place a claim and a truck or truck appears on your block that does not appear to have any identifying marks or workers taking the equipment or making deliveries, it is entirely possible that the monitoring will take place. If you have a disability such as fibromyalgia, where you can’t get out of bed on some days, and on other days when you feel almost normal, watching the video tape will only show you on a good day. This can create a difficult situation. If your medical records reflect the unforeseen nature of your illness, you have a better chance of meeting the challenge of a disability insurance claim.

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