You fought hard to get the long-term disability benefits you need to take care of yourself and your loved ones. But what happens if the insurance company cuts off your monthly payments while you’re still disabled and unable to work? Can they do that?
The answer is a resounding yes.
Disability insurance companies make more money when they do not pay claims. If they can find a reason to stop paying, they will.
Keep reading to discover the 5 most common ploys used by insurance companies to stop paying claims and how you can keep it from happening to you.
1. You Didn’t Apply for Social Security Disability
If you’ve been approved for LTD benefits, your policy will require you to apply for Social Security Disability.
This is because insurance companies are allowed to “offset” SSDI payments against LTD benefits (not pay you the amount you get from Social Security), so they have a strong interest in seeing you approved for Social Security disability.
Failure to file a claim with the Social Security Administration could result in your LTD benefits being terminated. Don’t let this happen!
Make sure to file your claim with the Social Security administration and keep a record of all your correspondence.
2. They Want to Claim That You’re No Longer Disabled
From time to time, the insurance company will want proof that you are still disabled. This could include yearly recertification from your doctor and evidence that you are keeping your doctor’s appointments.
If you stop going to the doctor, they may assume you are no longer disabled. Even if the doctor says there is “nothing they can do for you,” it’s essential to keep your appointment for all scheduled visits, treatments, and therapies.
Failure to keep your doctor’s appointments can also cause the insurance company to request an IME (Independent Medical Exam). These medical examiners are hired by the insurance company, so they’re anything but “independent.” Since they’re being paid by the insurance company, they’re heavily incentivized to find that you are no longer disabled.
3. They Use Surveillance Techniques To Try to Trap You
Remember that insurance companies make more money when they don’t pay claims? If they think you’re a fraud, they’ll use surveillance techniques in the hopes they’ll “catch” you doing something inconsistent with your disability.
They’ll look at your social media accounts (Facebook and Instagram) and even have someone follow you, taking photos and videos of you. And you won’t even know it (a discreet smartphone takes very clear video). They want to make you look like a liar.
The easiest form of surveillance is done from a desk using a computer. Consider everything that is online as potentially incriminating. Insurance companies troll social media sites using the most invasive kind of surveillance – looking up pictures that claimants post of themselves.
Here is an example: Our firm recently had a person call us that had been terminated by her disability insurance company. While investigating her claim, we discovered that the disability adjuster had cut off her benefits after finding some pictures of her running in a road race (a 5k). Our client’s daughter had posted them and tagged her. It sure looked like she was out running a race…while she was receiving disability benefits!
The disability insurer didn’t bother to ask about the pictures before cutting off her disability check. No, they just terminated her claim. However, once we spoke to our client, we found that the photos were from two years before she became disabled!
Was this good surveillance for the disability insurer? Of course not. But we still had to fight for several months to get them to reverse their decision and start paying her disability claim again.
Set your social media accounts to PRIVATE—but be aware that sometimes those settings can be tricky. For example, you’ll think you’ve set them to private, and they’re not.
Don’t give them any ammunition to use against you!
Don’t post anything the insurance company can interpret in the wrong way. And make sure you tell your friends and family not to “tag” you in photos that can be misleading.
Assume when you leave the house that someone is recording you.
You can learn more about how insurance companies use surveillance tricks HERE
4. They Find a Discrepancy In Your Paperwork
Any discrepancy in your paperwork can set off an alarm in an insurance representative’s head. Remember, it’s their job to save their company money, so they sit behind a desk combing through mountains of paperwork, hoping to catch you in a slip-up.
The most common discrepancies occur when two statements (usually one by your doctor) says one thing, but you’ve stated something else in another document.
An example would be if you stated that you cannot sit for longer than ten minutes without being in pain, but your doctor states that you’ve indicated you can now sit for twenty minutes. As innocent as those two statements may sound, that could be all it takes for an insurance rep to look for other inconsistencies which could lead to terminating your benefits.
5. They Change the Definition of Disabled
While it might not seem fair, it’s common for insurance companies to “reset” the definition of disabled—usually at the 2-year mark—even if your condition has not improved.
The definition change usually refers to a shift from an “own occupation” definition (meaning the job you are trained for and had at the time you were disabled) to an “any occupation” definition (meaning ANY job for which you have the required education, skill or experience).
This means the insurance company can require you to get any job you might be able to do, even if it means working in a totally different field for much less money than what you made previously.
While this might sound discouraging, keep in mind that this is just their interpretation of your case.
Luckily, our legal system isn’t owned by insurance companies. If your LTD carrier tries to force you into “any occupation” you can appeal.
At Tucker Disability Law, we fight insurance companies every day on behalf of our clients. We’ll review your policy and your case carefully. We know all the tricks insurance companies use to cut off your disability benefits. It’s our job to keep on top of the best strategies to fight these tricks and help you keep the benefits you deserve.
If you have a concern about your LTD benefits, we can help. You can click this link to schedule a free consultation or call us at 866-282-5260.
