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Insurance Disability

What to Do If Your Insurance Disability Claim is Not Paid

If your insurance disability claim is rejected by the insurer, you might be left without any money to pay for medical expenses associated with the disability. If you had paid your monthly premiums and all the requirements of the insurer had been met, then there should be no reason for the insurer not to pay out.

What is Disability Insurance?

It is a type of insurance policy that provides cover for the insured party against loss of income and expenses associated with a disability. A disability insurance policy pays out when the insured party is injured as the result of an accident or illness and becomes disabled unable to work. The policy is meant to provide the insured party with income.

If you, for instance, work as a hairdresser, but due to an accident, you lose one of your hands, you will not be able to perform your normal duties as hairstylist without undergoing special training to work with one hand. You thus suffer a disability that makes it difficult to keep earning an income from styling hair. In this instance, you claim disability insurance to pay for medical costs and to ensure income.

The payout can be in the form of a lump sum or over a stipulated period. Regardless of how the payout works, the insured party has the right to expect payment if they have paid their premiums and had met the requirements of the policy agreement.

Submission and Appeal of an Insurance Disability Claim

It is possible to contest the insurance disability claim rejection or to claim higher payout where relevant. Once the insurer has rejected the claim or has not made the awarded payment, it is imperative to immediately seek legal guidance.

You need legal assistance from an attorney specialising in personal injury, medical law and insurance disability claims. Without such legal assistance, you may very well find the insurer to be uncooperative and with all the legal procedures to deal with, your appeal may fail simply because of some type of technicality.

What Can the Lawyer Do?

The insurance disability attorney will study the terms and conditions of the policy and will call in a medical expert. The attorney will assist you in obtaining a copy of your medical records and will review the claim rejection letter. In addition, the lawyer will see to it that the necessary legal steps are taken, including correspondence with the insurer and will do so within the applicable timeframe.

The attorney will also assist you in gathering evidence in support of your claim or appeal. Where needed, the lawyer will inform you and assist you in getting an expert medical opinion, undergo the necessary tests and get the written witness statements from colleagues and family members.

Call on Adele van der Walt Incorporated for professional legal guidance regarding insurance disability claims.


Information in this article is not intended as legal advice and is only for informational purposes. Please seek legal guidance from Adele van der Walt before relying on this information to make any legal decisions.

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