Law Offices of Lawrence Mann
259 Oak Street, San Francisco, CA 94102
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What You Can Expect When You Make a Disability Insurance Claim

Making Insurance Claims in San Francisco01

The following are typical techniques that disability insurance carriers use to evaluate and deny your claim:

  1. Obtain your medical records. Gaps in treatment, lack of objective findings, not complying with treatment are arguments the carrier will use to attempt to deny coverage.
  2. Obtain your work records. For example, your calendars; work product; billings; accounts receivables, income and expenses; patient codes with bills.
  3. Obtain your income tax returns.
  4. Contact your medical doctors. The carrier will attempt to get your doctors to admit key facts: limited length of disability; lack of restrictions and limitations from performing your job duties; confirm lack of objective findings; confirm gaps in treatment.
  5. Contact witnesses. For example, witnesses to your job duties right before disability (assistants, co-workers, supervisors, clients); your post disability activities; your disabling symptoms; any disabling incident. Have their conservative in-house medical personnel review your paper medical records, and make conservative, pro-company conclusions.
  6. Require that you be examined by a conservative, highly credentialed doctor that makes a living from examining insureds on behalf of insurance companies.
  7. Require that you submit to an interview with a highly trained representative of the insurance company (often with law enforcement or psychological training). This will cover your prior work duties, the way you performed your work, the amount of time you performed each duty each day, a description of your work records, your medical condition, medications, why you cannot work, what restrictions and limitations you have from working, what you do after becoming disabled, a list of all of your doctors.
  8. Require that you submit further financial and other records, on an ongoing basis.
If you have long-term disability (LTD) insurance and become unable to work, you should hire an experienced LTD attorney as soon as possible to maximize your chances of success.