4 Steps You Can Take If You've Been Denied an Insurance Payout by Your Provider

You work to pay your premiums on time and expect the coverage to be there when it is needed. When denied an insurance payout, you can begin to feel overly stressed and overwhelmed. It is important you are able to recognize your rights as a policyholder so those rights can be protected. Knowing the steps to take after an insurance denial is essential.


Why Are Insurance Claims Denied?

It is natural to feel frustration when a Metlife claim has been denied. Understanding the common reasons for denial can help you to react appropriately when a claim is denied.

● A lack of medical evidence is a common reason for long-term disability denials. Extensive medical records are essential when filing a disability claim. The single most important piece of evidence is the doctor’s statement. If this statement does not back the claim, the claim is likely going to be denied.

● Another reason for denial is a failure to meet the stipulations of the policy’s definition of disabled. Each policy is different and the definition of disability can change over time. When purchasing disability insurance coverage, it is imperative you carefully read the policy’s definition of disability.

● Disability claims are also denied due to pre-existing conditions. These limitations typically apply for the first year of coverage with any long-term disability policy. If a claim is denied due to a pre-existing condition, it can often be difficult to appeal.

4 Steps You Can Take After a Denial

Insurance companies are working to protect their bottom line and they will often deny claims, even when there is substantial medical evidence to prove disability. If you have been denied an insurance payout, make sure to take these four steps.

1. Carefully review your denial letter to become aware of the reason for denial. Being aware of why the insurance company denied the claim will help you to take the proper actions.

2. It is imperative you start the appeal’s process as soon as possible after the denial. Most policies allow for at least two administrative appeals. You can even take an appeal to the federal level.

3. Gather your medical records and a copy of the insurance policy. The more evidence you have to submit in the appeal, the better the chances of a reversal decision.



4. Hiring a lawyer may be necessary if the appeal’s process seems complicated or you feel the insurance company is dragging its feet on the claim.

Taking these steps is important for protecting your rights in the appeal’s process. Your disability policy is meant to be there when you need it. When denied, you can hold the insurance company accountable.

Should you choose to hire a lawyer, doing so as soon as possible will offer rights protection and guidance. The process of filing an appeal is often easier and less stressful when legal help is sought early in the process.

Conclusion

Disabled individuals have the right to file a long-term disability claim with their insurance company. When denials are given, individuals need to be aware of the rights they have to appeal. Taking the above steps will help to protect your rights and help to ensure the approval of any disability benefits that are owed from the coverage.


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