The Insurance Company Isn’t Automatically Right

The insurance company said it, but does that mean they’re right?

A former client came to us with a letter stating that his benefits had been denied since 2017, despite the fact that we had gotten his benefits reinstated and paid for the past five years.  The letter also stated that he owed the insurance company all the money the insurer had sent him for the past five years as an overpayment.  The letter also stated that the client was being sent to a collections agency for the money they claimed he owed (on the first notice no less).

After some diligent enquiry with the accounts receivable department, we were able to determine that a coding error had occurred when the letter was generated.  The letter was simply meant to be a benefits exhausted letter, as the former client was at the end of the age period for which benefits were payable.  The insurance company said they would be correcting the error and contacting the collections agency to clear up the mistake and letting them know there was no outstanding balance.

Just because the insurance company tells you something doesn’t automatically make it true.  What would have happened if the former client had automatically paid the monies the insurance company said he owed?  What would have happened if he hadn’t picked up the phone and called our office before taking any action?

If you have a denial letter which states that you aren’t entitled to your disability insurance benefits or any other unfavorable letter from a disability insurance company, call us to review the correspondence and see whether we can offer assistance.  Remember, just because the insurance company told you that you owe them, are not disabled, or are not entitled to any benefits, doesn’t mean they are right.

If you liked this article, please consider sharing it!