Yet another ruse used by disability insurers is the scam that alleges that “objective evidence” is required as proof of disability. To begin, let me say that there is no disability Plan or contract on this planet I am aware of that requires “objective evidence” as proof of claim. Surprised? Don’t be. Your Plans and policies don’t require “objective evidence” as proof of claim.
Still, insureds and claimants will see this sentence in their denial letters, “There is no objective evidence to support medical restrictions and limitations.” What about FMS and CFS, named Syndromes, Depression and Anxiety? There is no objective evidence to support these diagnoses other than patient history and clinical observation. Does that mean insurers don’t have to pay for these disabilities? Not at all.
To be clear, “objective evidence” is defined as tests, lab reports etc. that prove you have what you, and your doctors, say you have. Nearly all ERISA Plans and IDI contracts define disability as “unable to perform the material and substantial duties of your own, or any other occupation.” Proof of claim means “Proof” you are unable to work.
Insurance companies have been using this ruse in their communications and denial letters for 30 years I am aware of. It was an out of Plan/contract requirement then, and it still is now. Insurance companies may NOT deny claims because insureds didn’t submit objective evidence that’s not required as proof of claim in the first place.
Insureds still get lured into believing this ruse. If you don’t believe me, pull out your Plan or contract and look for provisions where it says you have to provide “objective evidence.” You won’t find it, because it isn’t there.
