Why Physicians are Special Targets for Unfair Claim Denials  

The Big Picture

As a doctor or other medical professional who has filed a disability insurance claim, you’ve likely learned that the insurance company will distort reality to deny your legitimate claim. 

Medical professionals and providers, from physicians, nurse practitioners, physician’s assistants, certified nurse anesthetists, dentists and nurses are especially targeted by the insurance companies for denial, because their earnings are high relative to the typical disability insurance claimant.

In fact, the same goes for attorneys, executives, and many others whose incomes are above the mean. The higher the claimant’s income, the higher the monthly disability benefit, and the more costly it is to the insurer’s bottom line. And with most policies entitling you to benefits to age 65 or normal retirement age of 67, just one claim can easily cost hundreds of thousands to millions of dollars over the life of the claim.

Multiply that by the huge number of claims the insurer denies each year across the country, and… you get the picture. Their entire business model involves maximizing premium revenue while minimizing claim payment costs. Your claim is just another cost. Denying your valid claim affects their bottom line the same as denying an invalid one.

To combat the high cost of paying benefits, many insurance companies write long-term disability policies for healthcare providers with provisions that serve as a high hurdle for getting their claims approved. And if your claim is governed by federal ERISA law (short for the Employee Retirement Income Security Act of 1974), as most are, another layer of difficulty is added to getting your claim approved as discussed below.

J. Price McNamara Author Image

J. Price McNamara


Losing my own brother, then my father and sister after long, disabling illnesses just a few months apart drove a career change for me. Before that experience, I never truly understood the place you’re in. I never understood the dramatic impact that receiving (or not receiving) the disability and life insurance benefits you paid for and counted on can have on your life especially when you need to focus on family and healing. What I experienced with my own family now drives the way I view my clients and my work, and I will never forget it!

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