FAQ – Okay, I got the plan. Now what does it say? | Clearwater Long Term Disability Attorney

Congratulations! You’ve gotten the summary plan description which is just what it says – a summary of the plan. Let’s hope you got the policy.

Sometimes we find that there is a difference between what’s in the plan and what’s in the policy. For the sake of this posting, I will just talk about what’s in the disability policy.

Remember when I said there was no uniform disability policy in the United States. There are, however, some basic things I look for when I review a disability policy.

1. Is there a provision that requires you to have a policy for certain length of time before you can claim entitlement to disability benefits? If so, how long is it?

2. Is there a provision that excludes certain physical or mental conditions from coverage? If so, what’s excluded?

3. Is there a provision that limits coverage for certain physical or mental conditions? If so, what are those provisions, and how long is the coverage?

4. What is the definition of disability? Does the definition require objective proof of your disability?

5. What is the elimination period or the time you must be disabled before you are entitled to receive benefits?

6. How does your plan define occupation? Is it your occupation? Your occupation as performed for your employer? Your occupation as performed in the national economy? The Dictionary of Occupational Title definition of your job?

7. What is the claims process? When do you have to put the disability carrier on notice of your claim? How many appeals can you file? How long does the disability carrier have in which to make a decision?

8. How much are your benefits? Is there a set off against your disability benefits that will reduce your long-term disability benefits? Does that set off include Social Security benefits, your children’s Social Security benefits? Workers’ compensation or pension benefits?

9. Is there a limitation in the policy on when you must file suit?

10. What is the track record for this disability insurance carrier denying claims? Settling claims? Litigating claims?

Without knowing the answers to these questions, you are setting yourself up for a denial of your disability claim.

Nancy Cavey’s book, “Robbed Of Your Peace of Mind“, is a must read if you’re going to have any chance to avoid making mistakes, even before you file a disability claim.

If you have any questions, please give us a call at 727.894.3188 or contact us online by clicking here.

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