Individual Disability Policy & Claims Denial " Nightmare"

We are not affiliated with any insurance company.

[Home] [Insurance Quotes] [Follow Ups] [Post Followup]
[100 Insurers Message Board] [FAQ]

Posted by jan (207.49.223.82) on December 30, 2001 at 17:03:08:

These disability carriers - _____
One case: Medical Doctor/accidently shot off his finger. Carrier paid for about 3 years under the total disability definition for "Own Occupation" his doctor and IME said "doctor can not perform his duties of OB/GYN ....totally disabled. Carriers position after three years is that doctor intentional shot off his finger. Disability policy may pay approximately 60 percent of previous salary. Carrier is saying the doctor intentionally shot his finger off.

Or, do you have a claim that was denied because your doctor may not have written out the limits and restrictions and then carrier denys the claim? Seems to be a favorite?

Is there any claim form from a disability carrier that actually ask the question according to policy language " can employee perform essential functions of job" or can employee perform main duties of occupation or is employee totally disabled? Why not?

Do any ERISA carriers or Individual Disability policy claim forms ask that on their claim forms ask any specific questions on their claim forms which inquire or state the proper questions? Why not?

Do we have a problem here? I am seeing lots of messages on this board. Claims have been denied and the insureds don't understand why? Do we have problem here?

How about Reservation of Rights letters? Do insured understand what it says or does it leave it you guessing? Do you write and ask? Do you get some BS reply? What is going on?

Follow Ups:

Post a Followup

Name:
E-Mail:

Subject: Re: Individual Disability Policy & Claims Denial " Nightmare"

Comments:
: These disability carriers - _____ : One case: Medical Doctor/accidently shot off his finger. Carrier paid for about 3 years under the total disability definition for "Own Occupation" his doctor and IME said "doctor can not perform his duties of OB/GYN ....totally disabled. Carriers position after three years is that doctor intentional shot off his finger. Disability policy may pay approximately 60 percent of previous salary. Carrier is saying the doctor intentionally shot his finger off. : Or, do you have a claim that was denied because your doctor may not have written out the limits and restrictions and then carrier denys the claim? Seems to be a favorite? : Is there any claim form from a disability carrier that actually ask the question according to policy language " can employee perform essential functions of job" or can employee perform main duties of occupation or is employee totally disabled? Why not? : Do any ERISA carriers or Individual Disability policy claim forms ask that on their claim forms ask any specific questions on their claim forms which inquire or state the proper questions? Why not? : Do we have a problem here? I am seeing lots of messages on this board. Claims have been denied and the insureds don't understand why? Do we have problem here? : How about Reservation of Rights letters? Do insured understand what it says or does it leave it you guessing? Do you write and ask? Do you get some BS reply? What is going on? :

Please enter the characters in the image above.

[Home] [Insurance Quotes] [Follow Ups] [ Post Followup] [100 Insurers Message Board] [FAQ]