<![CDATA[Denied Claims Archives | Scottsdale Personal Injury Blog]]> tag:www.adelmangerman.com,2013-03-21:/blog/75035 2017-09-01T18:33:06Z Movable Type Enterprise <![CDATA[Will your insurance company deny your disability claim?]]> tag:www.adelmangerman.com,2017:/blog//75035.2728505 2017-08-30T13:00:00Z 2017-09-01T18:33:06Z NO to claim request.jpeg

Cancer, a heart condition, severe arthritis and mental health issues are some of the most common causes of career-ending disabilities. While some jobs can be performed with work condition modifications, the high-functioning business professionals cannot fall back on simple accommodations. Nor can they switch easily to a new line of work.

This is why many business owners, medical professionals and self-employed individuals purchase private disability insurance policies. In the event of a disability, a private policy is supposed to provide benefits if you are unable to perform the duties of your chosen profession. Unfortunately, many disability claims are denied.

]]> Disability claims are frequently denied

A quick Google search makes it appear as if insurance companies deny more disability claims than they approve. Just review a few court case examples filed within the three months:

  • Life Insurance Co. of North America denies man's claim for short-term disability benefits claiming he did not have sufficient medical records to back up his claim
  • Cigna Insurance Group denies woman's claims for short-term and long-term disability benefits after an award for temporary disability benefits despite medical proof that she is disabled from gainful employment
  • Principal Life Insurance Company denies Arizona man's long-term disability claim after providing short-term disability benefits for a chronic foot condition, which kept him from performing his work duties as a manager
  • Northwestern Mutual Life Insurance Co. denies man's disability claim for PTSD and other debilitating ailments after allegedly ignoring his own doctors' opinions
  • The Lincoln National Life Insurance Company denies woman's claim for benefits alleging that she is no longer disabled

A cursory online search reveals additional claims again Unum Life Insurance Co. of America, Aetna Life Insurance Co. and Prudential Insurance Co. of America that include allegations of failure to properly process claims and failure to provide full and fair claim reviews.

Don't take "no" for an answer

If your claim has been denied, you are not alone. Don't accept your insurance carrier's decision. Choose, instead, to fight back with the help of an experienced attorney.

]]> <![CDATA[Will genetic sequencing lead to more denied insurance claims?]]> tag:www.adelmangerman.com,2017:/blog//75035.2719910 2017-08-22T22:00:00Z 2017-08-24T15:22:15Z DNA test.jpeg

If you think that DNA testing has revolutionized medical care and criminal identification, just wait to see what it may mean for your insurance coverage.

Genetic testing has advanced far beyond DNA tests that help identify biological fathers and criminals who leave evidence behind. You can order a test kit online and even find out the genetic makeup of your mixed-breed dog these days.

]]> Medical professionals routinely test genomic data to determine if family members carry the same genes as their mothers, fathers or siblings in order to proactively identify and prevent the onset of deadly diseases. There is no doubt that genetic testing has helped thousands of people prevent illnesses before they start. But, how far can and should testing go?

Genetic testing of healthy individuals

Earlier this summer, the results of a whole-genome sequencing study of healthy people were published. Indicators of rare diseases were found in 22 percent of the study participants, but only two participants had any true symptoms.

The researchers -- and others who debated the value of genetic tested -- grappled with a number of concerns that may arise as more healthy people are tested:

  • Will patients be unnecessarily frightened by what might happen in the future?
  • Will genetic discoveries lead to expensive and unwarranted medical tests?
  • Will testing results be used against patients in other aspects of their lives?

A law and genetics expert from Arizona State University immediately raised the concern that insurance companies may use genetic sequencing results as reasons to deny claims for benefits.

Another reason to deny long-term disability benefits

Fortunately, the Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits health insurance companies from using genetics to make decisions about granting coverage. However, GINA does not keep life, disability, and long-term care insurers from using test results to deny benefits when their insureds submit claims. Some fear that the mere presence of a genetic mutation may -- one day soon -- be construed to be a pre-existing condition.

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