Common Reasons Insurance Companies Deny Claims

My name is Stephen Roger Bosin. As an attorney with more than 30 years of experience, I am well-versed in the reasons given by insurance companies for denying claims:

  • No Objective Findings: The long-term disability claim reviewer may deny your claim on the grounds that although you may be experiencing disabling pain, there are no "objective findings" to substantiate the disability.
  • Not Disabled From Your Occupation: A reviewer may deny your claim on the grounds that although your job may have unique, strenuous, or stressful requirements, the occupation as defined by the national economy generally does not have such requirements and, under those less demanding standards, you are not disabled.
  • Pre-Existing Condition Exclusion: The disability insurance policy may contain up to a 12-month pre-existing condition waiting period.
  • Failure to Fulfill the Elimination Period: Most policies have a requirement that a claimant be continuously disabled during an "elimination period" in order to be eligible for benefits.
  • Not Under the Care of a Physician: Most policies require that you be under the "regular care' of a physician. This is especially critical since you generally have to back up your claim with clear medical evidence.++

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