What To Do When Aflac Denies Your Long-Term Disability Claim
Aflac prides itself on being America’s largest provider of supplemental insurance. But when it comes to paying, Aflac turns into Uncle Scrooge. Just like any other insurance company, Aflac throws a myriad of reasons into legalese just to say, “We don’t pay, you’re on your own.”
So what do you do when that happens, especially if your condition requires you to miss work for extended periods?
Simple! You contact an Aflac ERISA long-term disability insurance attorney because everybody needs help from time to time. An insurance attorney is your best friend to battle it out with Aflac.
But first things first. It’s important to understand why your claim was denied. Finding out the reason will make the legal process a lot easier.
Reasons Why Your Claim Was Denied
Aflac can deny a long-term disability claim for multiple reasons. Some are valid, some are not so valid. It is up to you to decide whether you’re going to give up and accept your fate or take the fight to Aflac.
The reasons for your claim denial can be any of the following:
- They made an administrative error
- You missed a deadline to file a long-term disability claim
- The medical condition/injury doesn’t meet the insurance policy’s definition of disability
- Your condition/injury is not covered by the policy
- You lack evidence to support your claim
- Their medical examiner disagrees with your condition
- Their investigation revealed inconsistencies
- You already had that condition
Now that you know the reasons, let’s find out what you must do if Aflac rejects your long-term disability claims.
The Steps To Take If Aflac Denies Your Long-Term Disability Claim
Receiving a denial letter from an insurance company when you’re recovering from an injury can be heartbreaking. You signed up for the insurance policy, hoping that it would be useful in times of need. Well, you have a need now, and Aflac is throwing their hands up. The fact that you paid all your monthly premiums without fail just rubs salt in the wounds.
Fortunately, there are a few steps you can take. They are:
Analyze The Denial Letter
Aflac isn’t going to call you and inform you that your claim was denied. It’ll just send a signed letter.
What you have to do is thoroughly go through the denial letter. Analyze every single sentence. Don’t forget to cross-check the terms and conditions of your insurance policy.
Analyzing the denial letter sheds light on whether the denial was a fair or an unfair one. If it is unfair, the analysis will reveal elements that you can use in your appeal.
Gather Allies
As sad as it sounds, you cannot handle this alone. You need all the help you can get.
Most long-term disability claims are denied on the grounds of exaggerated injuries. If that is your case as well, look for the assistance of qualified healthcare practitioners. Ask them to give written statements that support your injury/illness and that you need the requested time off of work to completely recover.
Appeal Their Decision
Once you have gathered enough evidence, it’s time to appeal the decision. Aflac allows up to three appeals per claim. You’ll also have to fill out a form and submit all the evidence you have gathered.
Approach A Lawyer
There are increased chances that Aflac will reject your appeal as well. When such a situation arises, it’s time to lawyer up. Get in touch with an experienced insurance attorney to find out what your options are.
It helps to hire an attorney while filing an appeal. This will considerably reduce the chances of you making mistakes in your appeal.
Final Thoughts
Getting a long-term disability claim denied can be a punch in the gut. But it is important to gather yourself and fight back.
Battling it out with the insurance company is the last thing you need when recovering from an injury/illness. Hire a long-term disability lawyer and get through the process with ease.