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    Private ltd

    My LTD insurance has canceled my claim due to 2 year mark, they told me I need to go to work somewhere/anywhere. Even if it meant flipping burgers to provide for my family, they don't seem to understand my ms issues. My heat intolerance hits with very little change in my body temp. and makes me dizzy and blind in my left eye not to mention the fatigue in my arms and legs, the battle never ends..

    #2
    What does your MS neuro say about your disability/recovery?

    Is it possible that your Neuro is late submitting required paper work to the insurer?

    Insurance co's are required to issue an EOB, provide you with an explanation in writing befor terminating your LTD benefits.

    Terminating your benefit payments must meet legal requirements and must meet the terms in the LTD policy.

    Legally, you have a limited period of time during which you can dispute denied benefit payments. The instructions to dispute termination of benefit payments should be included in the Explanation of Benefits sent to notify you that payments are terminating. General instructions to dispute insurance company decision should also be in your policy.

    Contact your local chapter of the NMSS for a referral to an attorney who specializes in Disability Insurance Disputes.

    I know this is the most distressing news you could possibly hear. Let us know how you are doing and best of luck to you.

    Comment


      #3
      Also, if your insurer is not following your policy terms, for instance failing to notify you in wirittng or any other breaches of the insurance contract, contact your state's Commissioner of Insurance.

      You can request information about the insurer's status in your state and to file a compliant.

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        #4
        LTD

        My neurologist told them I will only get worse and will never return to work. My LTD ins. co. told me it was not enough to be disabled per requirements. My DR said he dont know what else they want. Thanks..

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          #5
          Have you contacted your state's Commissioner of Insurance to file a complaint?

          Do you have a copy of documentation your MS doc submitted to the insurer? If not, get the document from the doc ASAP. You need to know exactly what the insurance company is disputing.

          While your doctor may have issued a statement supporting your continued disability, the insurer may be demanding specifics about clinical exams and detailed diagnostic information from your MS doc to support his claim that you continue to be disabled.

          The clerical staff and doc's are not always on top of some of the specifics insurance companies demand.

          The intimidation tactics insurance companies engage in when dealing with very sick people is usually between you and the insurer unless you make it otherwise.

          It is often beneficial for the insurance company to demand, withhold, deny and intimidate until you can no longer defend yourself, until you find it necessary to give up the fight for benefit payments you no longer have the strength to continue.

          I would report this to the Commissioner of Insurance/ Department of Insurance in your state.

          Also contact the NMSS for referral to an attorney specializing in Disability Insurance Disputes.

          Consider contacting legal aid in your city/state.

          Call your State Rep, City Council person, State Senator.

          Comment


            #6
            Thanks for the help.. I need it..

            Comment


              #7
              Does not sound like you have a "private" plan, but rather an employer sponsored plan governed by the Erisa law.

              Those plans typically change from own occupation to any occupation after 24 months. In other words it will be harder to prove you qualify for the "any occupation" part.

              It is fine that a neuro says you cannot work, but more importantly he and you need to show why. In other words what are your restrictions and limitations that prevent you from working.

              People often seem to think that a disability automatically qualifies a person for benefits, but it is the restrictions and limitations that are important along with objective tests and the support of your doctors.

              If you don't know much about insurance lingo and what is required to appeal you might want to hire a couple of hours with an Erisa disability attorney (if your plan is an Erisa plan) or an disabililty attorney if your plan is a truely private plan.

              Start by reading your plan from start to end, not the summary, but the whole thing.

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                #8
                No problems....

                and good luck

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