Temporary Disability Insurance And Appealing Its Termination

Most employers offer temporary disability insurance to their employees, if you are denied a claim, quick action is required. Every state, and company policy, has different appeal guidelines so be informed about your policy coverage and rules.

Temporary Disability Insurance Defined

Temporary disability insurance, or short term disability insurance, is an income insurance policy. Most temporary disability insurance will cover up to 60% of your income, for a limited time period. The exact terms differ from state to state and between company plan policy.

If you are disabled by illness or injury, your first step should be to start the state and policy applicable processes. The waiting period varies so check your policy for requirements and time lines for submitting application, inquiries, and appeals.

What to do if your disability is terminated

The insurance company will notify you, in writing, that you have been denied or your benefits terminated. You will be given a reason and a time frame to file an appeal. If any documentation is required, you will also be notified of what they need.

In rate cases, you will not receive a decision within the policy's time limit and you will need to act fast. There will be a time limit to start the appeal process. First, you will need to get a lawyer and start the appeals process. Request your appeal in writing, as required by your policy. Include any necessary documentation. Send the appeal and all necessary items by certified mail. This will provide proof of the date it was sent and received. It will also show when it arrived and who signed for it. Make a copy of everything you send in.

The Appeals Process

There are a few levels to the appeals process. When you decide to appeal a decision to terminate your benefits, you will be informed of the processes to take and specific requirements of each.

    * Reconsideration is the beginning.  Your claim will be sent to a new department for reconsideration and different insurance adjuster will review your case. They will look over all of your paperwork again and make a decision. You do not need to be present for this reconsideration hearing.
    * Appeals council is the next step, if you are still denied after the hearing. The appeals council will work much like reconsideration.
    * Federal court is the final step for an appeal. If you disagree or are denied any other options, you may request a hearing.

Know your rights

Know your rights about your insurance policy. There are different rules and regulations in every state, and with every policy. Become as informed as possible before you apply for an appeal. Consult an attorney and make sure you have all of your evidence in order. It is possible to win, but it can take up to 2 years to finish the whole appeal process.

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