Deciding On A Tactical Move – Should You Appeal A Long-Term Disability Claim?

Insurance companies do not like to acknowledge an appeal, but all such companies have come up with an interesting means for covering up their hesitancy to grant any appeals. Each such money-making enterprise expresses a willingness to handle appeals internally. Yet, despite such an expression of willingness, in reality, few of those same appeals ever get overturned.

Problems Linked to a Request for an Appeal

An insurance company will not handle a denial until it has proof that a request for coverage has been denied. That proof needs to come in the form of a letter, a letter from the insurer. Moreover, the request for an appeal must be made within two years of the date on that same letter. If a client has made several appeals, and the submitted letter fails to match with the proper date (no more than 2 years earlier), then the insurer has grounds for denying the policy holder’s request (for an appeal).
Once one employee within the insurance company has handled a certain case, the same person will not be asked to respond to any request for an appeal. If that request does get granted, a new member of the insurer’s staff will handle the appealed claim. Naturally, the new person will have a fresh perspective. Moreover, after a series of appeals have been made, the record of all the reasons for denying a policy-holder’s requests weakens the argument made by that same injured policy holder, the one that has been hit with repeated denials of long term benefits.
In the mind of an insurer, a policy-holder’s decision to try appealing a denial looks like an invitation to take some drastic action. That action might include close surveillance of the person injured in an accident. At the same time, it could include the process of searching for bits of valuable information on all the different social media networks. Those networks would include social media sites like Facebook and Twitter.
Yet surveillance has proved more intrusive than any check of social media sites. If the person under surveillance knew that he or she would be watched closely for a limited amount of time, that surveillance might be tolerable. The subject of the insurer’s “eyes” could take steps to be more careful about his or her activities. Unfortunately, there is no guarantee that the insurer’s “eyes” will not be carrying out their intrusive activity for quite some time.

How the insurer arranges for each problem to re-enforce the others

By making an appeal’s denial a highly-likely event, the insurance company manages to delay the time when its lawyer must appear in court and argue the defendant’s case. That delaying tactic then gives the defendant in the court case (the insurer) more time in which to continue paying for surveillance of the man or woman that will become the plaintiff in the delayed trial. It is good to consult with an injury lawyer in Leamington.