Automatic Eligibility for Disability Benefits

In the private disability insurance context — in Illinois and elsewhere — insurers will often deny legitimate disability claims on the basis that the policyholder’s condition is not actually disabling in accordance with the language of the insurance plan.

There are no absolute rules that apply to all disability insurance policies — the definition of disability may differ significantly depending on policy.  Generally speaking, plans with high premiums have broader definitions of disability than cheaper plans.

For example, your plan may include a broad definition of disability that awards disability benefits in the event that your condition renders you incapable of working at your current job.  Some policies do not grant benefits for partial disabilities, while others grant full (or partial) benefits for such conditions.

In the overwhelming majority of private disability insurance policies, however, certain conditions will qualify the policyholder as “disabled” automatically and will therefore render them eligible for the immediate receipt of disability benefits.

Let’s take a quick peek at how it works.

The List of Qualifying Conditions

If you examine your insurance policy, you’ll likely find provisions that list out a number of possible medical conditions — such as cancer, or total blindness.  If you can prove that you are suffering from one or more of these conditions, then the insurer will have no choice but to accept that you are disabled (and pay out benefits).

This is a fantastic option for those who can still perform some of their work duties despite suffering from a serious medical condition.  For example, if you have late stage cancer, you might still be capable of working at your current job — normally you would not qualify as disabled, but thanks to the list of automatically qualifying conditions, you might still be able to access benefits.

Lists vary between policies, but common “automatic” conditions include:

  • Late stage cancers
  • Condition rendering you blind/deaf
  • Motor system disorders, such as MS/ALS/Parkinson’s/paralysis
  • Conditions affecting the cardiovascular system
  • And more

If you are suffering from one of the listed conditions, your insurer will likely attack your eligibility on two fronts: 1) they will undermine your claim for benefits by asserting that you are not actually suffering from the listed condition, and 2) they may preclude benefits through some other applicable exclusion (i.e., waiting period exclusion, intentional injury, etc.).  For example, the insurer might deny your claim for benefits — on the basis of paralysis — by bringing forth evidence that your paralysis is not full, and that you can still feel and manipulate your environment, albeit in a limited manner.

Given the likelihood of a dispute, it’s important to connect to a qualified attorney for early guidance on securing private disability benefits.

Contact Us to Consult With an Experienced Chicago Private Disability Attorney

If you have had a disability claim denied by your insurer, you may be able to challenge their denial and either resubmit a successful claim for benefits, appeal the denial, or bring an action against your insurer in a court of law.

Bryant Legal Group, P.C. is a Chicago-based insurance litigation firm with extensive experience handling a range of disputes, including those in which the insurer has denied an otherwise legitimate disability claim.  We have decades of experience representing disabled policyholders, and strongly believe that our commitment to client-centered legal representation has given us a competitive advantage.  We work closely with clients throughout the dispute process, keeping them informed and engaged every step of the way.

Call (312) 634-6415 today to get in touch with an experienced Chicago private disability attorney here at Bryant Legal Group, P.C.

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

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