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Signs Your Insurance Company Is About Cut Off Your Benefits

Having to go on long term disability is stressful. Knowing that you could be cut off at any time is even more stressful, especially if your healing is progressing slowly.

While it’s never an easy situation, there are some signs that you can watch for that will give you a clue about what your insurance provider is thinking in terms of your claim.

Sometimes You Have To Read Between The Lines

If you’re already on benefits, they’ll usually write you before your two year mark to tell you that you may not meet the requirements to continue. If you get this kind of a letter, it means that, most likely, the company is setting you up to be cut off.

The two-year mark is critical because the eligibility test changes from an inability to do your own job to an inability to any job for which you’re suited as per your experience, education, etc. Oftentimes the insurance company will fully acknowledge that you can’t do your current job, and they will set you up for vocational testing and training.

Kind Gestures Are Not Always About Kindness

It’s important to realize that, from the insurance company’s perspective, offering you vocational testing and training is not a kind measure to help you (although it can be a great opportunity to retrain and get you back into the workforce in a healthy way.) But from the insurance company’s view, it’s to prove that you can do something else so that they can end your payments.

So the question is, once you get to the two year mark, should you work with a lawyer if you think you’re going to get cut off? I’d wait to see what happens, although if you’ve already been working with a lawyer, take advantage of their expertise and get them to help.

Find Your Shadow

But once you’ve been denied, you should definitely see a lawyer. I’ve shadowed cases where people look like they may be cut off. For example, the adjuster has told them they probably won’t meet the test, but these people are in good shape because they already have a lawyer.

The rule of thumb is that, if you get an inkling that the insurance company is gearing to stop payments, this is when you want to chat with a lawyer. I’m not saying retain a lawyer – that’s premature – but if you come to see me because you’re worried you’re going to lose your benefits, I will still treat you like a client. Most people who do personal injury work will talk to you for free so my advice is to let us help.

Signs that your insurance company might cut you off:

  • Your claim is nearing the two year mark
  • They ask for more medical documentation, even though they’ve been silent for a while
  • They want to set up a meeting at your employer’s office
  • You get a letter from a rehab company working with your employer stating that they want to get you back to work
  • The adjustor hints or tells you outright in conversation (What is said orally and what is put in writing are different things, so sometimes they’ll tell you if they don’t think you’ll meet the test. Of course you can’t sue until they actually deny you, but you can certainly talk to me to get your ducks in a row.)

If any of these things happen to you, go see a lawyer. Even if the lawyer won’t meet with you, usually they’ll be willing to answer your questions and that’s a great start.

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2 replies
    • Derek Wilson
      Derek Wilson says:

      Hi Gordon,
      Generally they will notify you in writing. You might want to go back to see if you received something earlier on. You may have overlooked it or, if you recently changed addresses it may have gotten misdirected. Do you think that might be the case?

      Reply

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