Receiving a diagnosis or experiencing an injury that renders you unable to work can be overwhelming. Amidst the physical and emotional toll, the practical implications of lost income and mounting medical bills only add to the burden. For many, the natural course of action is to turn to their long-term disability insurance for support. Long-term disability (LTD) benefits can provide crucial income when you need it most.
However, the path to accessing LTD benefits is rarely straightforward. Insurance companies often employ tactics to minimize their financial liabilities, including denying or unfairly limiting legitimate claims.
In the face of such challenges, seeking experienced legal representation becomes essential. At Kantor & Kantor, our Fresno long-term disability claims lawyers are committed to advocating fiercely for our clients. We understand the nuances of LTD claims and are equipped to challenge insurance company denials through strategic appeals and, if necessary, litigation.
Do not let insurance company tactics deprive you of the benefits you rightfully deserve. Contact Kantor & Kantor at 818-886-2525 to schedule a free consultation and learn how we can help you secure the financial support you need.
We offer a free case evaluation to discuss how our lawyers can assist you. Contact us now at 818-886-2525 for a free consultation.
What Is Long-Term Disability Insurance?
Long-term disability (LTD) insurance is a type of coverage designed to provide financial protection to people become unable to work for an extended period of time due to an injury or illness. Unlike short-term disability insurance, which typically covers disabilities lasting up to six months, LTD insurance is intended to replace a portion of your income for an extended period.
These benefits can cover a significant portion of your income, ensuring you and your family are supported during challenging times. However, obtaining these benefits is rarely as easy as it should be.
Common Tactics Used by Insurance Companies to Deny LTD Claims
Here are some common tactics used by insurance companies:
1. Selective Review of Medical Evidence
Insurance companies may selectively review medical records to downplay the severity of your condition or overlook crucial evidence supporting your disability. They may focus on minor details while disregarding the overall impact of your impairment.
2. Surveillance
Insurers may conduct surveillance on claimants in an attempt to discredit their disability. They may hire private investigators to monitor your activities, looking for any evidence that contradicts your claimed limitations. Even if they do not observe you contradicting your stated abilities, they may try to portray whatever they do observe as somehow in conflict with your credibility as a whole.
3. Independent Medical Examinations (IMEs)
Insurance companies often require claimants to undergo IMEs by their chosen physicians. These exams may be biased towards the insurer’s interests, resulting in assessments that underestimate the severity of your condition or deem you fit for work prematurely.
4. Allegations of Malingering or Exaggeration
Insurance companies may accuse claimants of malingering or exaggerating their symptoms to prolong disability benefits unlawfully. They may use inconsistencies in medical records or subjective assessments to cast doubt on the legitimacy of your claim.
5. Policy Interpretation
Insurers may interpret policy language to favor the denial of benefits. They may exploit ambiguous terms or exclusions in the policy to justify their decision, even if it contradicts the original intent of the coverage.
6. Limiting Benefits
Most policies have limitations for mental health disabilities, capping the amount payable to two years of benefits. Insurers may try to classify your claim as primarily based on mental health issues despite your disability being primarily physical.
Common Reasons for LTD Claim Denials
Insurance companies often deny LTD claims for various reasons, including:
1. Insufficient Medical Evidence
One of the most common reasons for denial is inadequate medical documentation to substantiate the disability. Insurance companies require comprehensive, ongoing medical records demonstrating your condition’s severity and duration. They may argue that the evidence provided does not sufficiently prove that you cannot perform your job duties.
2. Pre-existing Conditions
Insurance policies often have exclusions for pre-existing conditions. If the insurance company determines that your disability is related to a condition that existed before your coverage began, they may deny your claim.
3. Policy Exclusions
Long-term disability policies may exclude certain conditions or injuries from coverage. Common exclusions include mental health conditions, self-inflicted injuries, or conditions resulting from substance abuse.
4. Administrative Errors
Clerical or administrative errors, such as missing information, incorrect forms, or missed deadlines, can result in claim denials. Even small mistakes can lead to a denial.
5. Lack of Objective Evidence
Insurance companies prefer objective evidence, such as test results and imaging studies, to support a disability claim. They may deny claims that rely heavily on subjective reports of pain or other symptoms.
6. Retaliatory Actions Against Claimants
In some cases, insurers may retaliate against claimants or their legal representatives for challenging claim denials or filing complaints, such as increasing premiums or threatening to cancel other insurance policies.
7. Ignoring or Misrepresenting Medical Advice
Insurers may ignore or misrepresent medical opinions and recommendations from healthcare providers to support their decision to deny benefits.
8. Lack of Transparency
Insurers may fail to provide clear explanations for claim denials, or the criteria used to assess disability, making it difficult for claimants to understand the reasons for the decision.
9. Unfair Surveillance or Investigation Tactics
Insurance companies may engage in invasive surveillance or investigation tactics, such as covert surveillance or social media monitoring, to discredit claimants’ disability claims.
Our attorneys at Kantor & Kantor will help you gather all medical records and other documentation.
Why Choose Kantor & Kantor?
Here is why we are the right choice for you:
- Experience and Expertise: With decades of collective experience in handling LTD claims, our team has the knowledge and skills to navigate even the most complex cases. We have successfully represented countless clients, securing the benefits they deserve.
- History of Achievements: We have a strong track record of success in securing benefits for our clients. Our firm has helped numerous individuals obtain the compensation they deserve, even in the face of denial or resistance from insurance companies.
- Zealous Advocacy: When it comes to advocating for our clients, we do not back down. Our attorneys are known for their tenacity and determination in fighting for our client’s rights. We will go to great lengths to ensure that you receive the full benefits you are entitled to under your policy.
- Compassionate Support: Dealing with a long-term disability can be emotionally and financially draining. That is why we provide compassionate support to our clients throughout the claims process. We are here to answer your questions, address your concerns, and provide guidance and reassurance during this challenging time.
- Client-Centered Approach: At Kantor & Kantor, you are more than just a case number – you are a valued client and partner in the legal process. We prioritize your needs and objectives to achieve the best possible result for you and your family.
Our experienced Fresno LTD claims attorneys have the knowledge and resources to hold insurers accountable for their actions and pursue the full and fair compensation our clients deserve.
How We Can Help with Your Long-Term Disability Case
At Kantor & Kantor, we understand your difficulties in obtaining the benefits you deserve. Here is how we can help:
Thorough Evaluation of Your Case
Our experienced Fresno LTD lawyers will thoroughly evaluate your case to determine the strength of your claim. We will review your insurance policy, medical records, and other relevant documentation to assess your eligibility for benefits.
Strategic Claim Preparation and Submission
Preparing and submitting an LTD claim requires attention to detail and thorough documentation. We will assist you in gathering the necessary evidence and completing the required paperwork to ensure your claim is submitted accurately and on time.
Claim Denial Appeals
If your claim is denied, we will not hesitate to challenge the decision through appeals. Our attorneys have extensive experience in handling claim denial appeals. We will thoroughly review the denial letter, identify the reasons for denial, and develop a strong appeal strategy. Whether it involves providing additional evidence, challenging the insurer’s decision, or filing a lawsuit, we will do whatever it takes to fight for the benefits you deserve.
Litigation Support
In some cases, litigation may be necessary to secure the benefits you deserve. If negotiations with the insurance company are unsuccessful, we are prepared to take your case to court and present a compelling argument on your behalf.
Contact Our Fresno Long-Term Disability Claims Lawyers Today
Your journey to securing LTD benefits starts with a simple yet crucial step: reaching out for help. Our Fresno LTD claims lawyers will work to build a strong case on your behalf. Our team will take the time to listen to your story, understand your challenges, and assess the merits of your case. We are people helping people and are here to make the process as seamless and stress-free as possible.
When you contact Kantor & Kantor, you can expect a personalized consultation tailored to your unique circumstances. Contact us at 818-886-2525 for a free consultation.
Attorney Glenn R. Kantor
Glenn Kantor is a founding partner of Kantor & Kantor LLP. As a young attorney, Glenn saw the injustice of wrongful insurance denials and created a law firm to represent individuals seeking to obtain their rightful benefits. Glenn is committed to ensure that clients receive the benefits they are entitled to under their insurance policies or group health plans. [Attorney Bio]
