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Disability Insurance: How To Complete The Claim Form

How To Complete Your Portion Of The Claim Form

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People often worry that what they say on the claim form is going to decide their claim. While it can be important, it's not worth worrying about. Just do your best.

The forms generally ask such questions as:

  • Basic identifying information (name, address, date of birth, Social Security number).
  • The name and mailing address of all your medical providers (such as doctors, clinics and hospitals).
  • When you first had symptoms.
  • When you stopped work.
  • About your health condition, including your symptoms. This is not always the case since the insurance company will mostly rely on your medical records for that information.
  • For you to sign a medical release so that the insurance company can obtain all your medical records. The insurance company won't process your claim without this release.

There are several things you can do to improve your chances of an approval:

Practice: Practice filling out the claim on a copy or on a pad before you submit a final draft. Know what you are going to say and how you're going to say it.

Don't, however, get overly concerned with neatness and spelling and appearance. The practice is for what you're going to say, not for neatness. Too messy may be unreadable. Then again, too neat may cause the people at the insurance company to wonder just how sick you are.

For example: Your occupation involved computer work, so it's easier for you to complete the form by computer. It comes out looking like a professional document. This won't necessarily cause a denial, but it may make the claims analyst wonder why you can't do computer work if your claim form looks so professional.

Mistakes: Correcting a mistake by crossing it out is okay. However it is not advisable to use "Whiteout". Whiteout can raise questions about what you're trying to hide.

If your symptoms include lack of concentration, short-term memory loss, or other brain function problems, don't attempt to hide how they affect your completion of the claim form. Also, if the form took hours to complete, say so and state just how long. It gives the company an idea of the difficulty you might face working if you have difficulty completing a form.

Space to answer a question: Don't let a limited amount of space on the form intimidate you.

It's very common for an insurance company to ask, "Why are you unable to work?" then give you only a tiny space to answer it. In such cases, write "See attached" and write your answer on blank paper.

At the top of each of the extra pages, include:

  • Your name.
  • The insurance policy number.
  • The question you answering. (Either note the question number, or repeat the question.)
  • The page number if you are attaching more than one page.

All questions: Answer all questions.

If a question doesn't apply to you, write "N/A" as an answer (or other term if requested on the form). For example, if you're male, write "N/A" next to "Have you ever been pregnant?"

Writing something like "N/A" lets the claim analyst know you didn't ignore or overlook anything.

Dates: Don't worry about exact dates for years past.

For example, the form asks when you first had symptoms of the condition. You've been dealing with it for four years and are filling out the form in the year 2013. It's ok to write, "Early 2009."

If there is a possibility that the insurance company can turn down your claim on the basis that you had an existing health condition at the time you applied for the policy, we suggest that you consult with a lawyer before completing the form. (To learn more, see: How To Choose A Lawyer.)

Symptoms and Job Duties:

If you are asked for symptoms, focus on those that keep you from working. Be specific in describing each symptom.

If you are asked about job duties, list all of them. Focus on the major job duties that you have the most difficulty performing.

To help hone your memory, consider completing a work and a daily activities worksheet. We include two types of worksheet: one of which only requests general information and the other requests very detailed information. You can choose which worksheet to use depending on how you view your chances of being determined to be disabled from a medical point of view.

Reasonable Accommodation: More and more claim forms are asking "Have you attempted to work with a Reasonable Accommodation?"

This question refers to the federal Americans With Disabilities Act which requires employers to make such accommodations to employees with a disability.

Check your policy to see whether it requires that you attempt such an accommodation before filing a claim. If there is no such requirement, answering "No" to such a question will not cause your claim to be denied. There is no need for you to include any detail in answering this question.

In fact, in many instances a reasonable accommodation is to reduce the number of hours worked. Reduced hours could reduce your salary and in turn could reduce any disability benefits for which you may then qualify.

Trick Questions: People have been known to be concerned when completing claims forms that there will be questions meant to trip you up.

We are not aware of any trick questions on these claim forms.

When you answer questions, instead of wondering if a question is a trick, think about how to answer the question in the manner most likely to obtain the insurer's agreement that you are disabled, while still answering the question honestly.

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