Disability Claimants Must Make Reasonable Attempts to Recover
In Illinois, policyholders may have their otherwise legitimate disability claims denied if they fail to exercise reasonable efforts in recovering from their disability (and otherwise mitigating their losses). As a general rule, policyholders must uphold their end of the contractual bargain, so to speak — the insurer is not an absolute guarantor of losses suffered by the policyholder. The insurer can only be held reasonable losses that arise due to the disabling condition at-issue.
Confused? Let’s take a quick look at the duty to mitigate imposed on disability policyholders in Illinois.
The General Duty to Mitigate
Throughout the country, insurance policyholders — including those who have a disability insurance claim — are expected to adhere to a “duty to mitigate.” This duty to mitigate requires that the policyholder make reasonable efforts to minimize their various losses in the wake of a disability.
Consider the following.
Imagine that you have been injured in a motor vehicle accident. As a result of your injuries, you are rendered disabled. According to terms of your private insurance contract, you qualify for disability benefits. However, after an initial consultation with medical professionals, you do not follow-through on treatment. Your disability becomes more severe. Your insurer denies your claim for disability benefits, citing the fact that you have not properly mitigated your various losses.
The duty to mitigate demands reasonable efforts. What constitutes reasonable efforts varies depending on the circumstances. As a general rule, however, the policyholder must follow the advice of treating medical professionals and be consistent in rehabilitating their disabling condition. If you skip physical therapy sessions for several months, for example, then the insurer will almost certainly use that information as a basis to deny your benefits claim.
In real-world circumstances, it is unlikely that an insurer will deny a claim for “failure to mitigate” unless there is a clear and significant issue involved. Minor problems — one or two skipped sessions, or a slight delay in making a medical appointment — will usually not lead to a mitigation-based denial. If your insurer denies your legitimate disability claim on such basis, then you may be entitled to bring a bad faith claim against them.
- Related Article: 5 FAQs About Private Disability Insurance Claims
Schedule a Free Consultation With an Experienced Chicago Disability Attorney
If you are suffering from a disabling injury, illness, or other condition, then it’s important that you work with your medical professionals to ensure that you are receiving adequate treatment for the disabling condition — failure to do so could undermine your claim for benefits. In some cases, however, insurers will try to avoid having to payout benefits by asserting that you have not made reasonable efforts to recover.
Here at Bryant Legal Group, P.C., we have decades of experience advocating on behalf of disabled policyholders, helping them to successfully resolve disputes with their insurers. We believe in personalized legal representation, and as such, we aim to involve our disabled clients in every stage of litigation. This client-centered approach has served us well. Over the years, we have secured a number of favorable verdicts and settlements on behalf of our disabled clients.
Call (312) 561-3010 to get connected to an experienced Chicago disability attorney here at Bryant Legal Group, P.C., today.
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