Aetna Disability Claim Denials

Insurance companies under the Aetna or Hartford banner collect massive amounts of premiums from everyday working Americans every year – in any one year that figure adds up to over $30 billion.

Unfortunately, though, when it comes to paying out on a claim, they often either delay payment or deny coverage completely – often using different interpretations of the terms of your policy to essentially leave you without the payout you deserve.

It is cheaper for Aetna insurance companies to retain teams of lawyers than it is to pay out on their policies – and they know that the individual making the claim cannot or will not fight them.

Don’t let them win.

Why does Aetna delay claims?

The fact is that Aetna, and other large-scale insurance carriers, make the bulk of their profits not from the premiums that you pay them, or even from the denial of payouts. What they actually do is take your payments, group them with other customers’ premiums and then invest that money – they are often some of the largest investors in the global economy.

This means that delaying your payment for as long as possible is in their best interests – the longer that they can hold on to the money that they need to pay out, the longer they can keep making more money from it.

If you feel that your payment is being unnecessarily delayed, then you need to get in touch with us. We will put pressure on Aetna, or any other insurance carrier, to make sure that your needs are taken care of. A delay for you could be life-changing, whereas them paying out on time simply means that they will make slightly less profit.

What can you do when Aetna denies your claim?

One of the most common tactics which insurance companies like Aetna use when they deny a claim is called ‘bad faith’ They act in bad faith when they look for loopholes or ambiguities to deny what is an otherwise legitimate claim. This is illegal behavior – and is the basis for our company. We believe that insurance carriers acting in bad faith are taking advantage of innocent customers at a particularly difficult time in their life, and we will do everything we can to hold them to account.

Examples of the type of behavior that we will fight are:

• Misinterpretation of the terms and conditions of your Aetna disability coverage
• Attempts to confuse or drown you in a sea of unnecessary paperwork and administration
• Using non-specialist/wrongly specialized medical professionals to assess your case
• Ignoring or minimizing medical information
• Lack of communication with you about your case

Handling Your Appeal

The first thing you may need to do if Aetna has denied your claim is to appeal. This is where you request, in writing, for the insurance carrier to take another look at your case – you send over your policy details and any and all medical information regarding your situation, and ask for a second opinion.

Unfortunately, your appeal needs to meet certain conditions – many of them to do with the timing of your request. Both Aetna and the regulations surrounding the insurance industry (ERISA laws) have strict rules about filing deadlines, so you will need the assistance of a long-term disability attorney to help you make sure that your appeal is filed both correctly and on time should ERISA apply.

When to reach out to an attorney for help.

Always consult with a disability attorney before submitting appeals. The strength of a lawsuit depends on the quality of the appeal.

Insurance companies want you to give up – they save money when you do. Don’t give up! We routinely go up against insurance companies and know what it takes to get your benefits. With so much at stake to protect your livelihood, don’t go at it alone.

Most firms do not provide continued support after your case is won, but we do. We provide you with additional care and protection, because insurance companies use tactics to avoid paying disability benefits after claims are won.