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Complaint 0 of 0 in "Claim for Benefits Denied / Delayed"

Insurance Carrier: Colonial Life and Disability
State: Mississippi

Consumer Complaint:

Coloninal Ins. co. continues to deny me under my current policy pymts 1,700 disability. They continue to say pre-existing. Contract signed for is anything prior to 9-3-08 (12) months is pre-existing. I was diagnosed with disability 10/9/08. They listed dates. I have neck injury the dates given were toenail infec/menopause/carpel tunnel/narcolepsy disability diagnosed 10/9/08 2 herniated discs. Then they said denied back pain/neck injury pre-existing made up diagnosis that don't exist, never seen/treated/diagnosed w/back pain. Now they said I had complaints of pain in my hands (carpel tunnel) test done/enclosed to them, relates to herniated disc and pain associated with it. They are costing me money I don’t have for doctor notes after doctor notes supporting evidence from him it is not pre-existing. Still refuse to pay. They are causing undue burden/stress to both my doctor, his nurse and myself.

Insurance Expert Answer:

Given the very short lapse of time between the start of the policy and the onset of the disability the insurance company would usually be concerned about the possibility of either a material misstatement on your application (assuming you bought an individual policy, and completed an application) OR a pre-existing condition if the policy were obtained through an employment relationship. These cases turn on the facts, and countering the claims department's assertions that the disability was caused by a pre-existing condition -- or something pre-existing is responsible for the problem -- is not something most people ate capable of doing on their own. Further, the stakes can be large, depending on how long the disability benefits pay out and your likelihood of recovery. While you could try to battle this on your own, usually folks, who do say things that damage their case, don't know how to assemble and put together the proper medical proof, and/or fail to file on time to meet the deadlines and thus lose. You'll need a lawyer to win this.