Disability Insurance Articles

The Role Of The Doctor In Disability Insurance Claims

2010-10-13

Disability insurance is a way for employed persons to ensure their financial viability in the event that a sudden illness or injury strikes. Whether it is short-term payment while a person gets back on his or her feet, or a long-term transition into managed care, disability insurance can help to ease the burden of being off work and the associated loss of income. Although most group and individual disability plans will not cover all injuries and conditions, and pay only a percentage of income, they can be an excellent way to make sure that a family is taken care of when they need it most. Of course, in order to access the benefits of the product, disability insurance claims must be made, and it is important to understand the role of your doctor in both the approval of a claim and the ongoing payment of benefits.

Disability insurance claims must begin with a doctor. In some cases, an insurance company will permit a patient's own physician to conduct an assessment and then pass on the findings to the insurance company. In other cases, the insurance company will designate a doctor of its choosing to carry out the evaluation of a patient claiming disability. This is largely done to prevent over-reporting of injuries, and to speed up the claims process as the doctor that the company uses will know the proper reporting procedure.

In addition to making an assessment, the doctor will typically also make a recommendation for treatment and recovery, and pass this recommendation onto the insurance company. Based on the doctor's recommendations, the insurance company will set out a payment plan for the insured. If there is a dispute, patients can often take their claim to a review board or seek a second option from another physician. Once payment has begun, patients must be careful to communicate with their doctor and follow the recommendations laid out for them. If they do not and the insurance company can identify that they have not done so, it is possible that their insurance coverage will be revoked. Updated recommendations from the doctor must be followed as a patient improves, and the patient must obtain a clearance before returning to work and must inform the insurance company before doing so.

The role of the doctor is crucial in not only making disability insurance claims but in getting a fair settlement. Doctors should assess injuries in an unbiased manner, giving patients the best chance of getting the right amount of compensation for their claim. A great physician can make all of the difference between struggling through a claim and having a streamlined and fair process.