Why is Proof of Loss so Important in a Disability Claim?

If you have made a disability claim under an individual or employer-sponsored group long term disability policy, you no doubt have been bombarded with requests for documents and information in every possible form. Is this just a tactic the insurance company uses to harass and annoy you into submission? The not-so-simple answer is yes….and no.

Some of the information you are asked to provide, such as your unprivileged medical records and a completed form that provides the reasons why you cannot do your job, is extremely material to having your claim paid. In fact, courts have construed a disabled insured’s obligations to provide such proof of loss under his contract as a requirement and burden that if unmet, will result in a justified claim denial.

However, if you are being asked to allow access to your credit report or for five years’ worth of income tax returns, it could be within your rights to resist. The answer lies in your policy’s language. If you have arrived at the point of frustration with the insurance company’s persistent requests and have not yet read your policy cover to cover, stop, take a deep breath, get in a comfortable chair, and read the whole thing. Ask yourself whether the requests by the insurance company are justified by the policy language and make sure you have done everything the policy requires you to do to have your claim paid. When in doubt, call Gisonni Law Firm to understand your rights.