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Appealing a Denial of Disability Benefits from Assurant

Osterhout Berger Daley > Insurance Companies > Appealing a Denial of Disability Benefits from Assurant

Many employers offer their employees disability insurance through Assurant as a part of their benefits packages. Employees who choose this coverage pay their premiums by payroll deductions from their paychecks. This type of coverage can help employees to meet their needs if they are disabled on a short- or long-term basis. However, Assurant often denies claims, leading to the need to appeal. The experienced disability team at Osterhout Berger Daley represent people whose claims have been denied in their appeals.

Background on Assurant

Founded in 1892 and headquartered in New York, New York, Assurant offers a variety of insurance products in the health, life, casualty and property sectors. The company is publicly traded and has two primary operating sectors. It has around 17,500 employees.

Disability insurance from Assurant

Assurant offers short-term disability and long-term disability insurance products to workers through their employers. The company sells short-term disability products through payroll deductions to employers with three or more employees. The disability products are marketed and sold through Assurant Employee Benefits.

Assurant short-term disability insurance

Assurant’s short-term disability insurance is marketed as short-term financial solutions for people who are temporarily disabled and who have missed a minimum number of days from work, otherwise known as an elimination period. Typically, short-term disability plans pay a benefit amount on a weekly basis that is calculated by taking a percentage of your weekly earnings. Your employer may have chosen a plan that requires you to go through a waiting period in addition to an elimination period. This means that you may have to be employed by your company for a set amount of days, typically 30-90 days, before you’re eligible to file a short-term disability claim. In addition, Assurant may have a specific definition of a qualified disability. This means that certain disabilities or illnesses may not be covered by your short-term disability plan. The insurance company may consider certain disabilities to be pre-existing conditions and disqualify you from benefits. Make sure to read your policy completely to understand how it works and what qualifies as a disability.

Assurant long-term disability insurance

Long-term disability insurance through Assurant works similarly to the short-term disability plan. People whose long-term disability claims are approved will receive monthly benefits for a longer period of time than they would for short-term disability coverage. To maximize their coverage, some workers choose to purchase both short- and long-term disability coverage from Assurant. When their short-term disability benefits end, the elimination period for their long-term disability benefits will also end so that the workers can then begin receiving their long-term disability benefits.

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What you need to know about Assurant claims

While Assurant claims that it “has a strong history combining greater claimant assurance with an emphasis on recovery and return to work”, the company tends to place the greatest emphasis on getting people back to work. This is typically not beneficial for an individual who relies on the disability benefits to take care of their expenses while they’re recovering. Since Assurant places more importance on getting people back to work than paying benefits, they tend to send people running in circles to provide them with specific documentation. If that specific paperwork is missing from a person’s file, the Case Manager will delay and sometimes even deny that person’s claim. So, it’s imperative that you have all of the required documentation and paperwork completely filled out and turned in to your Case Manager so that they can’t come back with a reason to delay or deny your claim. Our experienced lawyers at Osterhout Berger Daley are willing to walk you through Assurant’s claim process to ensure that all requirements are met and you receive your benefits in a timely manner.

How do I submit a claim to Assurant?

Ask your employer or representative in charge of benefits for the exact instructions on how to submit your claim. You may have been given access to an online portal or your representative may require that you email, fax, or mail the claim forms instead. The forms you’ll have to complete will include your statement, your employers’ statement, and your attending physician’s statement. The required documentation will be the same for both short-term and long-term disability claims. There may be additional authorization forms you may be required to sign, so be sure that you double-check that you have all of the required paperwork prior to submitting your claim. Again, an experienced disability lawyer at Osterhout Berger Daley is available to help you throughout the entire process if you so choose to seek assistance.

What do I do if Assurant delays my claim?

If you believe that Assurant is delaying your claim, the first thing you should do is get in contact with your Case Manager if you’re getting a lack of response regarding your claim. You should be able to check the status of your claim online, but if the status is consistently the same for a week straight, it may be time to contact your Case Manager directly. If you still don’t get a response, you may want to seek legal help to get the process moving. If your being requested to provide an excess amount of documentation or specific paperwork, it may also be time to seek legal help so that your lawyer can help you acquire whatever paperwork the insurance company is requesting and intervene on your behalf with the submission of the paperwork.

What do I do if Assurant denies my claim?

If you are disabled and Assurant has denied your claim, you will be sent a letter notifying you of the denial. Your letter will list the reasons that the company used to deny you and tell you how to appeal. Prior to actually appealing your denial, your knowledgeable attorney will likely ask you to complete additional medical examinations and tests. This is because he or she will want to supplement your claim file with as much favorable evidence to your claim as possible. When you add more evidence, it becomes harder for the insurance company to deny your appeal. If you later are forced to file a lawsuit, you will only be able to use the evidence that is contained in your claim file, so adding as much additional favorable evidence as possible only benefits you. Your lawyer will also advise you to continue getting medical help for your disabling condition. If you stop attending your doctor’s appointments, the company will use this as evidence that you are not disabled. It is important to act quickly when you receive a denial so that you can preserve your rights.

Appealing a denial from Assurant

You must first follow the insurance company’s own appeals process before you will be allowed to sue Assurant in court. Your experienced lawyer at Osterhout Berger Daley will want you to request a copy of your claim file. He or she will review the information and make certain that your appeal is filed with Assurant before the deadline for appealing the decision has passed. If you let the deadline expire, you will be barred from later trying to recover benefits from the company for your disability.

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    Learn more about long term disability insurance, as well as appealing denials and how an attorney can help. These five articles will cover the basics: