After applying for individual disability insurance and paying premiums over time, a lot of people ask, “how do I file a disability insurance claim?”

The first thing to think about is the definition of disability on your policy. This will determine eligibility for a claim. Most individual policies have an own occupation definition of disability. This means if you are sick or injured and can’t work in your occupation (or medical specialty), you are eligible to file a claim. If you are unsure if you qualify, contact the company or your agent/broker for clarification.

Some claims can be more murky. They may not be a total disability. They may be a partial or residual disability. This means that if you have a 15% or 20% (depending on the policy) or more loss of income, the company will pay that proportion of your benefit. Oftentimes, people may not realize that they have a claim since they are still working but on a limited basis. An example is someone who is starting cancer treatment and is still working. They know that they will likely become sicker as time goes on but at the moment they feel fine. In this circumstance, I would recommend starting the claims process.

The next thing to look at on your policy is your elimination period. Most individual policies have a 90 day or 180 day eliminatinon period. That is the amount of time that must elapse before benefits are paid.

A lot of companies request that you file a claim within 30 days of diagnosis or accident. This is not always viable, especially if you are hospitalized or if you are unsure if your claim will be long term. If you are uncertain, you can always start the disability insurance claims process.

Once you have determined that you are going to file a claim, here is the process.

1. Notify the company. This can be by phone call or by filing a claim online.
2. The company will receive your form and contact you for more informaiton.
3. The company will likely request medical records from your treating doctor.
4. The company may require financial documents to determine loss of income.

If you also have a disability policy through your employer, you may also notify the company as their process may be different and have separate requirements.

Here are some links to company’s disability insurance claims requirements:

Ameritas
Guardian
MassMutual
Principal
Standard

For more information on filing disability insurance claims, contact Set for Life Insurance today!