Dr. David SeubertPROTECTION OF THE INSURED
If you are anticipating or experiencing obstacles in the application process for disability or life insurance coverage, allow me to provide preemptive guidance and assistance. It is always preferable to address issues before filing an application to optimize your ability to acquire coverage.
If you become afflicted with a serious healthcare issue or catastrophic injury, you depend on your disability insurer to maintain your income. If your disease or injury is recoverable and you can return to your licensed healthcare profession, temporary disability coverage may suffice. If your disability is permanent without the ability to return to your licensed healthcare profession, permanent disability coverage is needed. If your healthcare provider’s assessment of your condition is not congruent with your disability insurer, you may find yourself unable to practice your profession and without the coverage you depended upon.
If you are a beneficiary of a life insurance policy, an insured relied on the insurer to provide for your needs after the insured’s death. If the insurer declines to provide coverage for you as the beneficiary, you may face tremendous hardships. Do not fight this battle alone. Call on me to assist you.
My background as a medical director for a major healthcare insurer and advanced educational background in insurance law makes me abundantly qualified to guide and assist you. At times negotiations with your insurer along with your healthcare practitioner can resolve disputes without the need for formal proceedings. If negotiations are unsuccessful, I will fight hard to protect your needs and attempt to compel your healthcare insurer to provide for your medical needs.
FAQS My healthcare insurer has denied coverage for a surgical procedure that my provider states is essential. What can I do?
Negotiations with health insurers in concert with your provider often can be successful. If you are unsuccessful, navigating the appeal process can be arduous. Do not fight this battle alone. Call on me to help. Negotiations and appeals with your insurer are complex and require the assistance of a knowledgeable attorney. There are a limited number of appeals that you are entitled to. Therefore, it is imperative that your receive assistance as soon as your coverage is denied.
My spouse purchased a life insurance policy with exclusionary clauses for suicide and prior health conditions. My spouse became severely depressed after purchasing the insurance policy and committed suicide prior to the termination of the exclusionary clause. Is this an automatic bar to receiving life insurance benefits?
Exclusionary clauses for suicide and prior health conditions pose serious problems for insureds and their beneficiaries. At times there are circumstances that present that may trump exclusionary clauses and allow the insured or the insured’s beneficiaries to receive benefits. It is essential that prior to negotiating with an insurer, the insured or beneficiaries consult with a knowledgeable attorney with expertise in insurance law.
I received short term disability from my employer for a serious injury. The short term disability coverage period has ended. I have been denied long term disability coverage, however I am unable to safely return to work right now. What should I do?
Long term disability coverage is a very complicated process. The place of injury, type of injury and type of employment must be considered prior to applying for long term disability. At times, the interests of the employer and the employee are not aligned. Prior to applying for long term disability and negotiating with an insurer, it is essential to seek the advice of a knowledgeable attorney with expertise in insurance law so that your rights can be protected.
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