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Disability Insurance: An Attorney's Perspective
Disability Insurance: An Attorney's Perspective
This guide is intended as a practical resource for dentists who think they might need to file a disability claim.
Blog By:
Edward Comitz
Edward Comitz

Claim Tip 3: What to Expect When You Request Claim Forms

12/1/2017 9:00:00 AM   |   Comments: 0   |   Views: 655
When you make the difficult decision to stop practicing and file a disability claim, the first step is to request the claim forms from your insurer.  Each disability company has its own set of claim forms, and some companies have multiple sets of claim forms for specific types of policies (e.g. private policies you purchased individually v. employer-sponsored plans) or specific types of conditions (e.g. physical injury v. mental/psychiatric conditions).   So, if you have multiple policies from different carriers, you’ll have to request (and complete) a claim packet from each insurer.

While some insurance companies make these forms available online, most don’t, so you will likely need to call the company to request them.  When you call in, most companies try and conduct an impromptu interview, to catch you off guard and collect as much information from you as they can before you have a chance to see the claim forms, review your policy or talk with an attorney about the proper scope of a disability claim investigation.  Some of the topics that are typically addressed in this initial interview include, among other things:
                                                                                                                    
  • Your condition;
    •                                                                                                                 
  • When you think you can go back to work;
    •                                                                                                                 
  • The timeline of events that led up to making a claim (when did you first notice your disability, when were you diagnosed, did you keep working after the diagnosis, when were you first unable to practice, when did you sell your practice, did you keep working after the practice sold, etc.);
    •                                                                                                                 
  • Whether you have any pending board complaints or malpractice lawsuits; 
    •                                                                                                                 
  • The names and contact information of your medical providers;
    •                                                                                                                 
  • All the medications you are taking, and which pharmacies you use;
    •                                                                                                                 
  • Your job duties and plans for future employment; and
    •                                                                                                                 
  • Your daily activities and schedule (so that they can let their private investigators know where to find you when they conduct surveillance).
Even though it may seem like a friendly conversation, it is important to realize that the insurer’s scrutiny of your claim begins here, and the way you answer these initial questions, no matter how innocuous they seem, can greatly impact your claim.  From the outset of any claim, the company’s goal is to get you to say something that is inconsistent—either during the course of the call itself, or later on when you fill out the claim forms or are answering questions in a more comprehensive in-person interview.  Additionally, in many claims, the timeline of events significantly impacts the length of the benefit period, the amount of benefits due, and/or whether any benefits are due at all.  Consequently, it is very important to take the time to thoroughly prepare before making this important first call, so that you don’t inadvertently give your insurance company any ammunition it can later use to challenge your claim.


Information offered purely for general informational purposes and not intended to create an attorney-client relationship.  Anyone reading this post should not act on any information contained herein without seeking professional counsel from an attorney.
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