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Appealing a Denial of Disability Benefits from Assurity

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

Having disability insurance from Assurity may make you feel confident in your belief that you will have financial protection if you suffer from a disabling condition or accident. Unfortunately, Assurity denies many claims when they are filed. The experienced legal team at Osterhout Berger Daley has substantial experience in representing clients in their appeals of their denials of their claims by Assurity.

Background on Assurity

Assurity was founded in 1997 from the merger of three companies that dated back to the 1890s. The company is based in Lincoln, Nebraska and is licensed in 49 states along with the District of Columbia. Assurity has around 400 employees and uses independently contracted brokers to sell its insurance products.

Disability insurance from Assurity

Assurity offers short- and long-term disability insurance to workers. Short-term disability may offer covered workers a percentage of their regular salaries if their disabilities force them to miss work for a limited duration. Long-term disability benefits are available in terms of one, two or five years or up to age 65. There are some other coverage options such as receiving benefits if you are unable to return to your own occupation, cost of living adjustments and the return of premiums.

Assurity short-term disability insurance

Short-term disability insurance from Assurity pays out a benefit on a monthly basis that is determined by a percentage of your income. Prior to filing a disability claim, you’ll have to go through an elimination period. This means that you’ll have to be disabled for a set amount of time, typically anywhere between 30-90 days, before you can even apply to receive benefits. Some companies may even require that you go through a waiting period in addition to an elimination period. A waiting period is based on how long you’ve been employed by your company. You may need to wait until the 31st day of your employment before you’re even eligible to receive benefits or you may need to only wait one day. Confirm with your employer or read through your policy to understand how long you’ll have to wait before you can submit a claim for benefits.

You’ll also want to read through your policy to understand what exclusions may apply. Assurity may consider certain disabilities to be ineligible and elect not to pay benefits to individuals with these disabilities. This may include a normal pregnancy, a disability that resulted from war, a self-inflicted disability, etc. Your policy should cover all exclusions. You may also have a hard time qualifying for benefits if you’re able to collect Social Security Disability Insurance or any other supplemental income. Again, your policy should address all limitations and restrictions, so be sure to read through it carefully.

Assurity long-term disability insurance

Long-term disability insurance through Assurity works much in the same way as short-term disability insurance, but you’ll receive benefits for a longer period of time. Not only are benefits paid for a longer duration, but your elimination period will also be longer. Some workers choose to purchase short- and long-term disability coverage from Assurity. By doing this, the workers then receive money more quickly if they are disabled. Elimination periods must still be met before workers can receive their first checks. Workers may receive their short-term benefits during the elimination period for their long-term disability benefits. When their short-term benefits expire, their long-term benefits can then begin so that they will not have a lapse in payments.

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What you need to know about Assurity claims

It’s not uncommon for insurance companies to delay or deny claims. This helps the company avoid having to actually pay out the benefits and these companies are businesses first and foremost, so they care about the bottomline. The number one way that insurance companies avoid having to pay benefits to its policyholders is by placing a ton of restrictions within its policies. Assurity is no exception. By placing these restrictions, they often require an immense amount of paperwork so that you have to prove that you have a disability that is qualified under the company’s definition of a disability. If you miss one piece of paperwork, the company will drag out your claim process until you either give up or are no longer disabled. More often than not, insurance companies will even use the missing piece of paperwork to deny your claim. To ensure this doesn’t happen to you, you’ll want to make sure that you have all of the necessary paperwork from the beginning. If you’re unsure of what paperwork is required to submit a claim, one of our experienced disability lawyers can walk you through the process from beginning to end.

How do I submit a claim to Assurity?

Before submitting your disability claim to Assurity, you’ll have to either email, fax, or mail a notice to the insurance company letting them know that you want to submit a claim. Once they receive your notice, they’ll send you all of the necessary forms you’ll need to fill out. You’ll want to make sure that you have all of the require forms completely and accurately filled out. These forms will include your statement of the disability, your employer’s statement, your attending physician’s statement, and an authorization form that gives the insurance company permission to pull your medical records.

Once you’re ready to submit your claim, you’ll have to either email it, fax it, or mail it back to Assurity. You may need to submit all necessary paperwork within a set amount of time. The insurance company should give you these instructions, so make sure to ask if you don’t receive those instructions. If this process feels overwhelming to you, our lawyers at Osterhout Berger Daley can walk you through each step so that you can feel confident that you’re submitting all of the necessary documentation.

What do I do if Assurity delays my claim?

If you feel that too much time has passed since you submitted your claim, you may want to contact Assurity’s Claims Reporting and Services department to try and check on your claim’s status. If you still don’t get an answer, you may want to consider asking an experienced disability lawyer to intervene on your behalf.

If the process if being delayed due to additional paperwork, you may also want to consider legal intervention. This is typically a tactic insurance companies use to avoid paying benefits and often leads to a denial letter shortly after asking you to run around for additional documents. You deserve to get the benefits you’ve been promised and you shouldn’t have to wait longer than the elimination period to receive the financial help you need.

What do I do if Assurity denies my claim?

If you have been denied, you’ll want to appeal the denial. It is important for you to carefully read your denial notice. It will list the reasons for which the company is basing its denial along with information about Assurity’s appeals process. It is important that you do not fail to meet the deadline that will be listed in your letter for filing your appeal. If you do, you will be prevented from trying to claim benefits from Assurity for your disabling condition or injury. After you receive your letter, contact the insurance company and demand a copy of your claim file. The company must provide it to you if you request it, and it will contain all of the evidence that the company collected in order to deny you.

Appealing a Denial from Assurity

Once you’re ready to appeal the denial, bring your letter and your file to your experienced attorney at Osterhout Berger Daley. After reviewing the documents, your attorney will then advise you on how to proceed. Your knowledgeable attorney will likely ask you to do certain things, and it is important that you listen and follow the advice that you are given. Everything our disability attorneys do is geared to helping our clients win their appeals. You may be asked to continue seeing your doctor, which is important to help you build a record supporting your claim. Your attorney might also want you to submit to functional evaluations, take additional tests and secure statements from your doctor, former employer and your friends about how your condition limits you and your ability to function.

By building favorable evidence in your file, your attorney may help to increase the likelihood of your success on your appeal. Contact the experienced disability lawyers at Osterhout Berger Daley today to schedule a consultation.