All insurance companies send a denial letter when they reject an application. Some people even receive a letter stating that their benefits are ending, for a variety of reasons. This is known as a termination letter. Note that it is possible to appeal a termination letter. Any appeal to the denial letter must include the following:
• Your policy’s formal definition of disability
• The types of disability that your policy covers
• The reason(s) why the insurance company denied your LTD application
• The information from your medical reports to back up the denial
• The letter’s denial date
The letter’s denial date is the most important part of your letter. It’s the date at which the deadlines for filing your appeal officially start. These deadlines apply for both internal and external appeals.
What do You do if You Lost Your Denial Letter?
You’ll need either your original denial letter or a copy of your denial letter if you want to appeal the decision. There are two ways you can get a copy (if you lost the original letter) is to call your plan administrator and ask for a copy or ask your plan advisor for a copy.
What is an Internal Long-Term Disability Denial Appeal?
You’re better off filing an external appeal than an internal appeal since those (external appeals) tend to have a higher success rate. However, internal appeals do, at times, work. You ask your insurance company to reopen your claim when you make an internal appeal. Just keep in mind that they’re not inclined to do so since it’s not in their best interest or in their employer’s best interest to do so!
In a way, internal appeals help the insurance company since it shows the courts that they are being diligent and acting in good faith on your claim. But internal appeals take time to file and process. The reason for that is that the deadlines aren’t set in stone. Filing an internal appeal means that you will have to wait and that could cause you to miss important deadlines for an external appeal. There are times when internal appeals work out, but most of the time, they don’t. That’s why they’re generally a waste of time.
Long-Term Disability Denial Appeal
Your personal injury lawyer in Cambridge needs to take the deadlines into consideration when deciding which appeal is best for you. If deadlines are tight, then it would make more sense to skip the internal appeals process. The same is true if you want to win a settlement and have a better chance of having your LTD application approved the second or third time around.
Your claim was initially denied because you missed a doctor’s appointment. It would make more sense to file an internal claim after you have seen the doctor – the chances of having your application approved are much higher. It was because your application was denied because your doctor didn’t clarify something or because you skipped a treatment.