H. Dennis Beaver: Disability Insurance Companies Avoid Payments Due | Opinion

There are people across the country reading the story today who have a strong presence on Facebook and other social media, which puts them at risk of losing thousands of dollars every year, just like you. will see it in a moment.

But first, let me tell you about “Andy,” whose story is an example of “Big Print Gives and Small Print Gets”.

“Several years ago, I obtained group disability insurance for the employees of my insurance company. The policy says that the insurance will replace lost income if an employee becomes disabled and is unable to do their regular job.

“Andy had a stroke at home, leaving him partially paralyzed, with severe problems with his balance and speech. He tires quickly, has no endurance even now, two years after his stroke. He was receiving disability insurance benefits during that time.

“Although he can’t climb rooftops, he sometimes spends time in our office, chatting with staff and clients. He doesn’t get paid for it – he loves being around people. It is therapy to fight depression. His wife drives him here, but he can only spend a few hours there before becoming noticeably tired. He just can’t work.

“About a week ago the insurance company sent a letter with a link to a video of Andy in our office chatting with clients. The letter read: “As it is clear that he is able to work and deals with your clients, disability benefits end immediately.

“Sir. Beaver, this is so wrong! Andy can’t work! What can we do? Thanks for your advice, Jeff.

Denying claims / cutting people off happens more often

I handled Andy’s situation through two attorneys whose practices focus on disability insurance claims: Jason Newfield of Garden City, New York, and Alexander A. Palamara of Hollywood, Florida.

“I hear these stories every day,” Newfield says. “Disability insurance companies are clearly under pressure to deny legitimate benefits to those who qualify, and in many cases have been receiving payments for years. This effort to cut policyholders only got worse last year. “

“Disability insurance companies suffered a financial blow as millions of policyholders were unable to pay premiums, and due to Covid valid claims for disability and life insurance have significantly increased. Companies use age-old tactics by challenging obvious evidence of disability or, like Andy, trying to show that the person is capable of working, ”he says.

Time – 24 months and counting – Don’t let the video fool you!

Palamara considers Andy’s situation to be typical. “Often, after receiving benefits for 24 months, people are suddenly denied additional payments because, in most policies, the definition of disability will change around 24 months.

“During the first 24 months, an applicant must prove that he is disabled by his own profession. After 24 months, he is disabled from any paid activity for which he is qualified on the basis of his training, education and experience. Also, can they do a job that earns them 60% of their previous monthly earnings?

“Insurance companies rely on video surveillance, which can seem overwhelming, but never assume that all hope is lost! Just because a person can do certain things for a few hours does not mean that they are not disabled. That doesn’t mean they can work 40 hours a week, 50 weeks a year. The videos do not show that the person is down for the next two or three days, especially if it has exceeded the day it was taken under surveillance, ”he says.

Social media can sink your ship

“If you are applying for long term disability or receiving it now, be aware of the damage you can do to your case by painting a shiny and ‘too good to be true’ version of your life on Instagram feeds and Facebook deadlines, ”Newfield says.

“A lot of us want to present the world with a rosy picture of our lives, but it can backfire when you have a long term disability claim pending.

“More and more, investigators will comb social media for evidence they can extract out of context to suggest your claim is not legitimate.

“Try to stay away from social media if possible if you are intending to file a long-term group disability claim. Any activity on Facebook, Linked-In or Instagram where you travel, party, fly or take any action that the carrier deems incompatible with your restrictions and limitations will promptly result in a refusal.

If you receive a rejection letter

The two lawyers caution anyone faced with a denial of disability insurance benefits: “To understand that there are rights of appeal, but don’t deal with them yourself. Speak to a lawyer immediately.

Dennis Beaver practices law in Bakersfield and welcomes comments and questions from readers, which can be faxed to (661) 323-7993 or emailed to [email protected]. And don’t forget to visit dennisbeaver.com.

About Antoine L. Cassell

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