Should You File An Appeal If Your Insurance Company Decides To Deny Your Long-Term Benefits?

In order to answer that question, the policy holder that has been denied long term benefits must first consider the answers to several other questions.

Questions that the policy holder should be asking

If an appeal is made, who will receive the papers that get submitted during an appeal?

The insurance company will get that paperwork. That is the company that has already denied one request for long term disability payments. Why would the same company feel compelled to OK an appeal?

How strong will the appeal be? A weak appeal stands slight chance for being approved. The applicant does not know what was missing in the initial application because they did not seek the assistance of a personal injury lawyer in Burnaby. The applicant probably lacks a copy of the company’s policy, yet the denial was based on the wording in that particular policy.

Furthermore, the denial was supported by information that came from the insurer’s doctor. Typically, the applicant does not have a copy of that doctor’s report. That makes it hard for the denied applicant to mount a successful appeal.

Can the applicant afford the expected delay? Can the applicant deal with the consequences? Applicants that seek an appeal invite the chance that the lengthy process could force them to exceed the statute of limitations. Understand, that the insurance company determines when the statute of limitations begins.

If an applicant gets forced to exceed the statute of limitations, the same applicant loses an opportunity. He or she loses the ability to obtain any long term benefits from the insurer. The court will not hear a case, once the statute of limitation has been exceeded.

What alternative strategy could the denied applicant take?

The denial of long-term benefits may seem ridiculous, especially if the applicant has a decided disability. Consequently, in such a situation, it makes sense to consult with a lawyer. It pays to search for an attorney that has helped other families in a similar situation. The possible client takes advantage of the chance to enjoy a no-cost consultation.

A lawyer may be able to obtain an expert witness. That expert witness might introduce evidence that refutes any claim made by the physician chosen by the insurer. The uncovering of such evidence might force the insurance company to agree to the awarding of the long-term benefits.

If the insurance company persists in denying the long-term benefits, that denial can then be used as the basis for a charge of bad faith. If the lawyer can demonstrate bad faith on the part of the insurer, the insurer can be ordered by the court to restore the denied benefits. If the insurance company wants to stay in business, it will obey the court’s order.