If you’ve applied recently for long-term disability insurance, one of the things you should keep a close eye on is the processing time. The Employee Retirement Income Security Act of 1974, or ERISA, requires your insurance provider to decide on your filed initial and completed long-term disability application within 45 days.
Your insurer, however, can request a 30-day extension if the plan administrator is unable to arrive at a decision and require more processing time. After the first extension, your insurer can request another 30-day extension if more time is required. The insurance provider, however, has to provide you with an explanation of these extensions. All in all, the initial decision can take up to a lengthy 105 days.
Though the ideal scenario is to get your long-term disability claim as quickly as possible, certain factors can extend the overall processing time. These are:
Your Current State of Health
If you are facing a range of health problems, your insurance company will ask for your medical records. They will request more of these records when you have various issues with your health. Sadly, the processing time for each record request could take several weeks. On top of that, your insurer may require you to undergo additional testing to assess the impact of your disability. They may ask you to go through a Functional Capacity Evaluation (FCE) or an Independent Medical Examination (IME).
Response Time to Information Requests from Your Insurance Provider
Your insurer may delay — or in worse cases, deny — your claim if it is missing vital information. The processing time may also protract if you are unable to meet the deadlines set by your insurance provider. Delaying your responses, at the very minimum, can put your application at risk of denial.
The Cooperation and Prompt Response of Your Doctor
Since your doctor will be the one filling out the medical forms provided by your insurance company, the amount of time he/she spends on completing them will affect your application timeline. You can reduce the need to extend the decision-making process by making sure that your doctor delivers timely responses to your insurer.
Get Disability Claims Assistance from Our Law Firm
Some insurance firms are notorious for delaying processing in an attempt to avoid paying out claims. They may make up excuses for failing to return your calls, not receiving the required information you’ve sent to them, and asking further medical documentation already provided by your specialist. If your insurance provider denies your claim and you appeal, they may give you the runaround to avoid transacting with you and giving you the long-term disability benefits you need.
When you find that your insurance provider is unreasonably delaying the processing time of your application, and you need help to appeal a denied claim, you’ll need a reputable attorney on your side. With Haffner Law, you’ll receive the assistance you need to get the benefits you deserve.
Our experienced disability insurance lawyers will work with you to submit accurate and complete paperwork to the insurance provider. If your insurer denies your claim, we’ll review your case and help you appeal a disability denial. On top of that, we’ll pursue legal action against your insurance company if they are unfairly delaying the processing time of your claim.
Call 1-844-HAFFNER (213-514-5681) to arrange a free, no-obligation consultation.