Here at TSF Law, we believe client information and education is critical to the claims process. This article will provide you with knowledge surrounding disability insurance claims, health claim practices and methods of fighting a health insurance claim. Specifically, it will answer the following questions in detail:
- Why do Insurance Companies Deny Claims?
- Are insurance companies regulated?
- How can I fight insurance denial?
- What are some financing possibilities?
Why do Insurance Companies Deny Claims?
A recent report has revealed that individuals do not have the ability, financially, to fight insurance companies – due to the power and financial resources of the insurance company. (Fair Benefits, Faily Delivered)
Long disability claim battles mean victims of long term disability accidents or mishaps do not receive assistance in a timely manner. This can lead to dire health consequences.
Every year, approximately one-third of claimants hire lawyers to deal with their auto insurance companies to represent them in a denied claim.
Are Insurance Companies Regulated?
The justice system, and insurance companies’ decisions panels, are not being fairly delivered. The system “does not promote a timely, conflict-free means of deciding what care is needed and providing it to accident victims”. (Fair Benefits, Faily Delivered)
Specifically, this report outlines the fact that insurers are not providing the care which their customers deserve. It is in their best interest to control costs. This means they are not operating with their client in mind, and are more prone to deny claims or insurance claims.
The lack of care from insurance companies has an adverse effect on entitlements, whereby legal representation will insist on representing a victims’ will to:
“Maximize their entitlement rather than address their need” (Fair Benefits, Faily Delivered)
Unfortunately, in the case of large payouts, insurance providers, in the case of insurance denial, will pay out according to the amount of money – and not necessarily focus on the results of the claimant. This is not the way insurance should work. A Disability Claim Lawyer will help recoup your costs and provide adequate care workers for you.
How Can I Fight Insurance Denial?
Over the five-year period 2011-2015, an average of 9,000 claims (40 per cent) that went into dispute resolution failed to reach full and final agreement at the mediation stage and went on to an arbitration process, adding further time and cost to the system.
A recent report has also stated that unique cases, such as long-term disability claims, cannot be worked through a regulated claims system. Thus, the focus of healthcare must be met with a legal specialist. There are regulations bodies working towards shifting the landscape towards the benefit of accident victims, but as of yet this is not part of the legal system – nor is it a government mandate. Long term disability lawyers are the solution to a lack of government standardization.
TSF Law are lawyers for disability benefits – our specialty is geared towards dealing with insurance claims, long term disability clients, and persons with disabilities. We usually do not refer our cases out to other firms for a fee like other large firms practicing in Canada. Our retainer is based one that is considered by the Law Society of Upper Canada, as one of the “best [they’ve] seen”. We do not charge referral fees, and our openness is guided by our care for our clients’ best interests.
What are some financing possibilities?
Most of the research geared towards middle-class individuals has shown that financing a long-term disability claim is not an option. Your legal professional will usually opt to cover out-of-pocket expenses in order to keep your health at par, or, better than before. These costs should be absorbed by the Insurance Company later on – after all, it is because of their denial that your health is more at-risk.
Be careful of disability loan officers since the interest may be too high for you to afford, or, will not be recouped in your case. Again, the insurance company should be making payouts in the interim; it is their fault you have been put in such a situation.
Contact a Long Term Disability Lawyer Today
We understand the emotional stress you may go through during your time of crisis, and your road to recovery. Our team can help provide income replacement when you become disabled at work, a team to ensure you have physical support, and a legal organization that’s always there for you. Contact Us for a Free Consultation.
