Before filing a claim for disability insurance benefits, it is important to keep the following three things in mind:
You have to meet your policy’s disability insurance definition.
All policies define “disability” in different ways, which will affect whether you qualify for benefits. The two most common disability insurance definitions are “own occupation disability and “any occupation disability.” “Own occupation disability insurance” kicks in when you can no longer perform the job you had when you became disabled. In contrast, “any occupation disability insurance” only kicks in if you can’t perform any job at all.
There may be a waiting period.
This waiting period is known as the “elimination period.” You can think of it as a deductible measured in time instead of money. The disability insurance elimination period can last a few days for short-term disability insurance to two years for long-term disability insurance.
File your claim ASAP.
That’s because some policies have a deadline for initial claims. Filing promptly also means your payments will start sooner.
If your disability insurance is through your employer, you’ll want to contact your company’s HR department to file a claim. If you bought your policy on your own, you’ll want to contact your licensed insurance agent or disability insurance company directly.
Filing a claim for disability insurance starts with submitting a claim packet. It typically includes a:
- Claimant statement that asks you personal information and details about the disability you suffered.
- Employer statement that asks your employer questions about the nature of your job, how your disability affects your ability to do your job and if you qualified for any other disability benefits.
- Physician’s statement from the doctor treating you for your disability. Your doctor will be asked about your disability, how long you’ve had it, treatments you’ve undergone, and their thoughts on when (or if) you can return to work.
- Bank information form to receive your disability insurance payments via direct deposit.
It can take anywhere from a few weeks to a few months to hear back about your disability insurance claim. Common reasons for why disability insurance claims are rejected include:
- You didn’t meet the disability definition as spelled out in your policy.
- You misrepresented key information in your disability insurance application.
- The injury or illness is excluded in the disability insurance policy. (A common exclusion is for pre-existing conditions.)
- The illness or injury arose from an excluded cause such as drug use.
If your disability insurance claim is rejected, you may be able to file an appeal with the disability insurance company.
If it’s accepted, you will usually receive your first disability insurance payment the first day of the month after the elimination period ends. You will keep receiving payments until you can return to work or until your disability insurance benefit period ends.
The disability insurance income you receive, when you receive it, and how long depends on your particular disability insurance policy. That’s why it is important to thoroughly explore your options and understand your policy before you need it.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.
