Common Disputes in Short-Term Disability Insurance
Short-term disability insurance provides temporary wage replacement benefits in the event that you are suffering from a disabling condition, though the benefits apply for a very limited period of time — in most cases, short-term disability benefits are only paid out for six months to one year of proven disability. After sufficient time has passed that short-term disability benefits are no longer available, you may be eligible to receive long-term disability benefits (if you are still disabled and if you are a long-term disability policyholder).
Unfortunately, despite having paid for short-term disability insurance coverage — and relying on such coverage in the event of an accident or serious illness — policyholders often find that their insurer wrongfully denies or otherwise mishandles their short-term disability claim, making it increasingly difficult for them to secure necessary benefits. This is especially problematic in the short-term disability context, as the disabling condition may not last for a long enough period of time for policyholders to feel “justified” by the time, effort, and expense of extensive litigation.
If you’ve had a short-term disability claim denied or mishandled, then it’s worth speaking to an experienced disability attorney who can help you successfully challenge the decision of the insurer and secure the benefits you deserve. Before you get in touch with a qualified disability attorney, however, you may want to consider the type of issues commonly encountered by disability policyholders.
Let’s take a look.
Veracity of Information Included in the Disability Application
If a material fact (i.e., information relevant to the disability coverage) has been misrepresented on your disability insurance application, then your insurer may use that to justify the denial of your otherwise legitimate disability claim. In fact, depending on the nature of the misrepresentation, you may even be found civilly or criminally liable.
When disputing the insurer’s claim, the issue of “material fact” often lies at the very center of the dispute. Whether a misrepresentation involved a material fact depends on the circumstances. For example, if you misrepresented your medical history, and this would have given sufficient reason for the insurer to reject your initial application, then you may have your disability claim properly denied.
Lack of Evidence as to the Disability
In many cases, the insurer simply denies the claim due to lack of evidence. With the aid of a qualified attorney, you may not necessarily have to challenge the denial outright — in fact, you can gather the evidence necessary to prove that you are actually disabled (i.e., documentary evidence such as medical records, paystubs, etc.) and resubmit your disability claim.
Strict Definition of “Disabled”
Some short-term disability insurance plans have a stricter definition of “disabled” than other insurance plans. Whether your condition qualifies you as disabled under your policy is frequently a matter of dispute. As such, it’s critical that you and your attorney fully evaluate the policy language. For example, if your insurance policy defines “disability” as a condition that renders you unable to perform the duties of any job, then you’ll have to show that your condition is sufficiently severe that you cannot reasonably work in any alternative career (not just your existing one!).
Insurer Mishandled the Disability Claim
In the short-term insurance context, insurers frequently mishandle claims, often by undervaluing the claim or delaying the processing. Why? Insurers generally want to reduce their liabilities. If the policyholder is already overwhelmed with the repercussions of recovering from their disabling condition, particularly if the benefits only last for a limited period of time, then the policyholder is less likely to challenge the determinations of their insurer — they may simply resign themselves to the decision.
Contact an Experienced Chicago Disability Attorney for Legal Assistance
If you have had a legitimate short-term disability insurance claim denied, or otherwise handled in an adverse manner by your insurer (i.e., the insurer undervalued your claim or has caused an excessive delay), then you may be entitled to challenge the decision of the insurer under Illinois law. Under certain circumstances, you may even be entitled to sue and recover damages for bad faith.
Here at Bryant Legal Group, P.C., our attorneys have represented numerous disabled policyholders in Illinois in disputes — including those who are experiencing difficulties with their short-term disability insurance — and have helped them secure a favorable outcome. We are committed to client-oriented, comprehensive representation. We have decades of experience in handling insurance disputes and evaluating insurance contracts and medical records. We are therefore uniquely well-suited to navigating the complications typical of such litigation.
Call (312) 561-3010 today to speak with an experienced Chicago disability attorney here at Bryant Legal Group, P.C. During your free initial consultation, we will assess your disability insurance claim (and any adverse actions taken by your insurer) and develop a strategy for securing the benefits that you are owed.