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Disability Insurance: How To Complete The Claim Form

Employer Portion Of The Claim Form

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Whether your insurance coverage is through your work, or you have it on your own, your employer will usually be asked:

  • To verify your dates of employment.
  • To list your job duties and/or submit a job description of your position.

It is critical that the insurance company has an accurate description of your duties. It's the only way the company will know exactly what "your regular occupation" consists of so it can determine whether your health condition prevents you from doing your job.

Many employers' job descriptions are out of date or don't accurately reflect your actual duties. Even worse, general descriptions may not come close to describing your real job. Travel, for example, is often just hinted at in a description. If the employer says you "…supervise sales activities," this doesn't tell the insurer that the sales force is in six offices over three states and you're expected to visit each 6 times a year. Often it is the omitted duties that cause the greatest difficulty in performance.

The normal procedure is for employers to gather the information for a claims form and then send the completed form directly to the health insurance company. We strongly advise that you revise the normal procedure and ask the employer to give you the papers to send into the insurance company. You can explain your desire to do this as wanting to be sure that the package is complete and accurate before it is sent to the company. If you follow this suggestion you will know what was said by the employer so you can check it for accuracy. If the employer won't give you the form, at least ask to see what is written before it's sent.

Group Plans: If you are filing your claim under a group plan, the employer will be asked details that will confirm your eligibility and size of the benefit. Questions for the employer will include:

  • Your date of hire.
  • Date coverage began for you.
  • Last day you worked.
  • Salary at the time you stopped work.

Individual Policies: Even if your claim is for an individual policy, the insurance company will still request an employer's statement. If there is currently no employer either because you have not been working or because you are self-employed, the task of demonstrating that you are disabled is going to be much harder.

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