Most people don’t realize that, potentially, their claims could have been targeted in October (beginning of 4th Qtr.) for denial by year-end.
We are only three weeks from the end of December and I can assure you that insurance companies are working eagerly to find any cause to allege you do not meet the definition of disability in your Plan or policy. Year-end is the final profit objective and claims can be denied in 2025 even when managers know they don’t have cause.
I’m finding that insureds and their doctors are pushing the envelopes when it comes to deadlines. I also find insurance companies are asking for information much sooner than the policy allows. Both of these together are causing an uptake on “failure to provide denials.” Insurers are also denying requests for extensions that take deadlines beyond 12/31.
Since insureds are more inclined to try to manage their own claims, more and more denials are coming across my desk. In my opinion, “failure to provide denials” shouldn’t happen. Claimants and insureds have a duty to provide continued proof of claim and should be prepared to do that within 30-45 days of being requested to do so. I know I’m going to sound harsh when I say this, but there are insureds out there who “are so much in pain, or, so fatigued……or, weak, that they just can’t fill out the paperwork,” or so they tell me. They also can’t afford to pay someone to help them, and cry on the phone, “What am I going to do?” Well, you have to complete the paperwork and send it in. If paperwork is delayed nearing year-end, the claim surely will be denied.
So please, don’t give the Christmas Grinch cause to deny your claim before 12/31/25.
