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My insurance company admits that I can’t do my job but won’t pay my long term disability benefits. Can they do this?

12.24.08

What is written in your insurance policy will determine your entitlement to disability benefits. Most disability insurance policies have two definitions of disability. Generally for the first period of disability you are disabled if you can’t do your own job (called “own occupation”). Often the first period is two years.

After the first period of disability there is generally a change in definition. The second definition of disability is an inability to do any job (called “any occupation”). Any occupation is usually defined as a job similar to the one you were doing at the time you became disabled.

There are other terms of the policy that may disentitle you to LTD. The benefits may only be payable for a limited time and that time may have expired. You may not have complied with one of the terms of the policy.

If the insurance company has stopped paying your LTD get some legal advice. The insurance company may or may not be right. And don’t wait. You may only have a short time to act and get your benefits restarted. Taking advantage of insurance company appeal procedures does not stop the clock from ticking.


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