No denial letter but they stopped payment

1

I’ve actually had this situation before with a different insurance company, prior to my current one (it was a different employer. I’m with this company because I attempted to return to work in a less responsible/demanding position but ended up off again). So I think this might be an issue others have faced.

What is your recourse when the insurance company won’t pay you - either for a period of time for arbitrary reasons or “yet” or until you do xyz… but they aren’t actually sending a denial letter.

I’m feeling like I’m a bit in no man’s land. I can’t appeal or sue without a denial, but I’m not being paid.

2

They approved your return to work and then stopped paying you?

3

No, sorry, I guess I wasn’t clear.

I’m on LTD. I’m unable to work. I discussed leaving the country with my CM - possibly permanently - and that triggered them demanding I fill out a form giving them permission to access information about all border crossings. And they aren’t paying me until they receive the signed form.

So, they are both denying me payment and denying me a letter stating my claim is denied. And I’m feeling unable to fight this because i have no denial letter.

4

Ask a lawyer.

What is your objection to signing the form?
They WILL cut you off if you leave the country though (based on what they are doing now).
Do you have a summary of your policy?
I got a benefit booklet when I started work.
That might say if you can leave the country.
I think most policies say a person can leave for x length but not permanently.

5

I understand that they will cut me off if I leave the country. That’s the policy and that’s fine.

I object to being unduly scrutinized and made to “prove it” while they withhold funds, and not being given any recourse.

I can follow the rules they lay out, but they need to as well.

This is the benefit booklet.

IMG_0797
IMG_07971179×2556 424 KB

6

Yes. You can appeal or sue if you are not being paid. My position is always if you are not being paid, your claim is denied, whether they have put it in writing or not.

David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliable manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-917-7050 to speak with a member with our disability claim support team.