Today we are going to be discussing What are exclusions? Exclusions are circumstances, situations or certain disabilities which will not result in a payment of benefits. Many common exclusions in disability policies are disabilities that are related to war, armed aggression, service in the Armed Forces, taking part in a riot, voluntarily inhaling a substance not intended for consumption, intentional self-inflicted injuries even if insane, or commission of a felony. Pre-existing conditions are not excluded. Some policies exclude claims based only on subjective evidence or pain, or headaches.
The problem is that if you are not aware of the exclusion, you may be surprised by it if your claim is denied because of that exclusion. I call policies that will not pay a claim due to pain or a headache illusory or junk policies. You think you have a disability policy to protect you, but really it may not cover much. There is also a danger of inconsistent interpretation of some exclusions. An adjuster not familiar with case law and interpretation of similar provisions might decide to give different interpretation to exclusion than was previously the case.
Remember we are here to help if you run into problems. Call us at the first hint of trouble.
The lawyers in our firm are focused on helping people with disability policies and ERISA claims. We want to give you the edge in understanding your policy. Today, we want to help you understand what the term “exclusions” means in your disability policy. Remember our ERISA attorneys and long-term disability lawyers are here to help if you run into problems. Contact us at the first sign of trouble with your disability claim. Whether you or your client needs advice before applying or appealing for ERISA benefits such as long-term disability, short-term disability, life insurance, pension, or retirement, contact an experienced ERISA disability attorney at The Martin Law Group at 800-284-9309.