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You were in a serious accident or fell seriously ill and you can't work. You file first for short-term disability, and then long-term disability down the road. You will be assigned to an insurance adjuster who will contact you to collect more information about the accident or illness. The adjuster will probably ask for pictures of the accident, medical records, incident reports, and anything else that they can use to evaluate the situation.

However, you need to know that a long-term disability insurance adjuster from MassMutual or Guardian or any of the other disability insurance companies is someone that the insurance company hired to analyze the damages from the accident. Is he going to be looking out for your best interest? Would he put you in a fair and unbiased light so you can

receive a reasonable compensation from your insurance policy?

NO. Essentially, the insurance adjusters, especially disability insurance adjusters, have the task of minimizing the amount of money their companies have to pay out in benefits, even though you have faithfully paid your premiums for years. They are trained to look for ways to deny legitimate claims - and ERISA disability insurance policies are written to favor the insurance company, not you.  And these insurance adjusters will use anything they can get to try to downplay what actually happened so that the insurance company doesn’t have to pay you what you’re entitled to.

So in this tense situation dealing with insurance adjusters, what do you do?

Well first off, read your disability policy and get it analyzed by a lawyer if you need to, to make sure your medical condition or injury is covered under the terms of the policy, and for how long it's covered and what you have to prove to the insurance company about your level of activity - like whether you need to prove you can't do your job, or any job, and how all of that is defined in the policy.  If you're on long-term disability, make sure that you are faithfully getting medical treatment, know how to talk to your doctor about your long term disability claim, and order our free consumer guide to get started setting yourself up for success.

Next, remain calm and use common sense. After experiencing something as traumatic as a serious injury or illness, you’re probably extremely stressed and shaken. But you need to know that insurance adjusters are waiting for you to do or say something that they can use against you. Don't post your personal info on social media or try to tell your friends everything is great when your injury or medical condition has you down - insurance companies are trolling social media looking for "evidence" that you are exaggerating your symptoms or are able to work.

Make sure you know what to do and what not to do. For more information, read our free report "Claim Denied- The Ugly Truth About Disability Insurance." Download it online to learn the ins and outs on how to handle your ERISA long-term disability case and if your injuries are serious or your claim has been denied, you need a lawyer, how to choose the right lawyer to represent you.

Still have questions? Call us today at (202) 393-3320 to find out how to protect yourself.  And if you have been denied long term disability and received a denial letter, you may have only 180 days to file an appeal - this is a lot more involved than filling out a form, so call us today and we'll give you a free analysis of your denial letter to get you started.

 
Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer
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