Disability Insurance Documentation Checklist
A Checklist for Preparing Long Term Disability Insurance Documentation
A. _ Prepare and maintain a detailed diagnosis, the recommended treatment, limitations, and expected progression of the condition.
B. _ Understand the duties of the claimant’s occupation or (with Any Occupation) of any occupation for which he/she is suited.
C. _ Carefully document what the claimant can, and cannot, do in the way of usual and customary duties.
D. _ Understand the definition of “Totally Disabled” contained in the policy. Do not assume “Totally Disabled” means incapacitated
E. _ List of the medications prescribed, side effects, and contraindications.
F. _ Be aware that all disability insurers use surveillance, hidden cameras, private investigators and other such devices as part of their claims investigations.
G. _ Abide by the terms of the policy, including any time limitations and document request requirements, but note that many states prohibit insurers from demanding tax records.
H. _ IME (Insurance Medical Exam) Ask to record the examination. Cooperate with the insurer’s doctor but remember he/she is not there as a treating physician. IME doctors are there to help the insurance company.
I. _ Note that under most disability policies, while on disability the carrier waives the duty to pay premiums, but premiums must be paid when not on disability.
J. _ Note: sometimes an insurer will attempt to “buy out” a claimant’s policy for a cash payment that relieves the insurer of further obligations. Calculate the policy’s PV (Present Value) by multiplying the monthly benefit by the number of months remaining over the life of the policy. If there is no COLA (Cost of Living Adjustment), a discount rate deduction may be applied. Ask an insurance accountant or lawyer for assistance on this.
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