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Disability Insurance

DeeDee

Asked by DeeDee,

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DeeDee Contributor

DeeDee

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This has nothing to do with the VA. But I hoped you guys and gals might have some advice. I enrolled in disability insurance offered to employees where I work in 6/06 (outside company Genworth Financial). In 8/06 I was told my bladder and uterus had prolapes and needed a hysterectomy. Missed 5 weeks of work, so I filed a claim. Got a letter over the weekend stating I was deined since I had been treated for a urinary track injection in 2/06. Can they get away with this. I'm sure if my bladder had proplapsped then it may have caused my UTI. But who can say that for sure. The first time my doctors found the prolapsed bladder and uterus was in 8/06. I'm really ticked, money is tight and next month is Christmas!!!

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JR Reihs Mentor

JR Reihs

Posted
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Deedee,

You need to read your policy........I would think that they are saying that this was a preexisting condition , and therefore not covered in the limits set by the policy.

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DeeDee

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I know that, my question is how can they say that a urinary tract infection is the caused my bladder and uterus to prolapse. Lots of people with normal bladders & uterus get UTI's. Saying the UTI in Feb is related to the hysterectomy & bladder tact is at best a guess on their part. I have read my policy, be pretty dumb not to....

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Guest jangrin

Guest jangrin

Posted
Posted
This has nothing to do with the VA. But I hoped you guys and gals might have some advice. I enrolled in disability insurance offered to employees where I work in 6/06 (outside company Genworth Financial). In 8/06 I was told my bladder and uterus had prolapes and needed a hysterectomy. Missed 5 weeks of work, so I filed a claim. Got a letter over the weekend stating I was deined since I had been treated for a urinary track injection in 2/06. Can they get away with this. I'm sure if my bladder had proplapsped then it may have caused my UTI. But who can say that for sure. The first time my doctors found the prolapsed bladder and uterus was in 8/06. I'm really ticked, money is tight and next month is Christmas!!!

DeeDee,

you can appeal the insurance company decision. Most companies have an arbitration board or committee. What you will need is the doctors statement that when he examined you, there was no prolapse. Submit his letter and tell them you want riembursment for your lost revenue. If they do not you will be sending your evidense to the insurance commisioner and will be filing a formal complaint.

You should be able to get reconsideration. The claims person is not a doctor they are a claims adjustor, and they cannot diagnose a condition especially if your have an MD backing you up. The MD that examined you back in February should be able to state that from his medical notes from your treaqtment back then.

Jangrin B)

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Guest jstacy

Guest jstacy

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Posted
This has nothing to do with the VA. But I hoped you guys and gals might have some advice. I enrolled in disability insurance offered to employees where I work in 6/06 (outside company Genworth Financial). In 8/06 I was told my bladder and uterus had prolapes and needed a hysterectomy. Missed 5 weeks of work, so I filed a claim. Got a letter over the weekend stating I was deined since I had been treated for a urinary track injection in 2/06. Can they get away with this. I'm sure if my bladder had proplapsped then it may have caused my UTI. But who can say that for sure. The first time my doctors found the prolapsed bladder and uterus was in 8/06. I'm really ticked, money is tight and next month is Christmas!!!

These Disability companies are governed by ERISA law. They deny almost everything and usually in bad faith. It is imparative that you seek an attorney and do it with haste. The Attorney will get the medical opinion you need. DO not delay on this issue for the time limits are very strict and the only thing that will over turn one is a favorable SSD ruling.

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john999 Grand Master

john999

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Istacy

That is very true. I have disability insurance. I paid premiums for 17 years and then when I became disabled it was very dicy about getting my benefits. I did get them, however, but I would not hesitate for one minute to take the insurance company to court if they try and stop my payments. I have to recertify every year via a doctor that I am still disabled even though I am on SSDI and IU P&T from the VA.

For any vets who are able to get disability insurance it is a great thing. If you have any serious disabilities you probably will not be able to get a policy. Mine only pays me $675 a month but it is tax free and they pay for life. I don't think they write policies like that anymore.

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Guest jstacy

Guest jstacy

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John, you are totally correct. I have been on LTD for 2 years and they keep trying little tricks like getting Physicians statements.

These insurance companies are extremely crooked and it almost always takes an attorney to handle them.

Life insurance companies arent much better either.

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Philip Rogers Grand Master

Philip Rogers

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All insurance companies are in the business to make money.

It is cheaper for them to deny a claim than to pay it.

For every claim that is appealed many more are not appealed this is were thay make there money

Thay are tossing the dice you don't have the wisdom to fight them......

Take there sorry ass to court, when you win they pay for your lawyer too.....

Some months back Terry recommended a book about how the insurance companies try to screw us. It's an excellent read. They work the same way as VA and SSDI.

pr

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