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Insurance Disability Claims

Many Americans every year become disabled because of injury or sickness. Although the injury or sickness can be financially devastating, in some cases, the financial burden can be offset by insurance disability benefits. However, in order to be entitled to these benefits they must have been contracted for prior to the onset of the illness or injury.

It is very important to note that each insurance disability policy must be reviewed before a determination can be made regarding applicable benefits. However, insurance disability policies still usually follow the same guidelines.

The guidelines found in many policies are as follows:

The claimant must have developed a sickness or must have been injured after the effective date of the policy;
The claimant must be disabled such that he/she can not perform the main duties of his/her occupation because of the injury or sickness;
The claimant must be under a physicians care during the time that he/she is disabled;
The condition rendering the claimant disabled must extend beyond the applicable elimination period; and
The claimant must report the disability to the insurance company within a prescribed period of time (usually 60 days) from the onset of the disability; or, if notice can not be provided within the prescribed period of time for some particular reason, as soon as reasonably possible.

As indicated, there are many conditions and events which must occur before a claimant may be entitled to insurance disability benefits. Furthermore, even though the claimants physicians may render him/her disabled, the physicians hired by the insurance company may have different opinions. When the physicians disagree, it may come down to a battle of the medical experts and lawyers.

If you or a family member have become disabled due to an accident or sickness, and you or the family member have insurance disability benefits, then you or the family member may be eligible to file a claim. However, persons seeking to preserve any potential legal claims should contact an attorney promptly because the contract and/or Texas has mandatory time periods ("Statute of Limitations") in which a claim and/or lawsuit must be filed.