How Berkshire Life Insurance Denies Disability Claims

How Berkshire Life Insurance Denies Disability Claims


Berkshire Life Insurance Company of America is the subsidiary of Guardian Life Insurance Company. Over the years, a lot of policyholders have fought the Berkshire in and out-of-court in the disability insurance claim process. If your disability claim with Berkshire, it means you are not getting the financial assistance you deserve. But, a good Berkshire disability claims lawyer can help you overturn the denial.  The following are the common reasons the insurance company will deny claims:

Hiring a Third-Party Doctor Who Will Allege You Don’t Have a Disability

Berkshire and Guardian hire doctors to perform medical reviews. Usually, they look for third-party companies that only serve the disability insurance industry. Policyholders should be concerned whether these doctors have been provided complete information and whether they make influence-free opinions. Usually, these reviewing doctors will choose medical records and cite issues in these records but don’t acknowledge the parts that support the disability claim. Because the insurance consultants don’t’ even meet you in person, they won’t know how you have been impaired by your condition and what caused your symptoms.

Using the Results of Medical Examinations Performed by their Doctor or Psychologist

The insurance company may also send you for a medical examination with a company doctor or psychologist. Because the exam only takes up to 30 minutes, it provides just a limited picture of how your condition affects your abilities. Often, the results of the exam are not accurate compared to your policy definitions and work requirements. 

Hiring a Doctor to Speak with your Doctor

Sometimes, your doctor can be caught unprepared for the call of a Berkshire-hired doctor. Without access to your record, your doctor may be forced to agree you can return to work. Also, the insurance doctor may misreport the conversation. A seasoned disability lawyer knows how to guard against this process.

Asserting Your Occupation is Less Demanding than it Actually Was

Berkshire and Guardian may request doctors’ CPT billing codes or dentist CDT billing codes to suggest you were not working your specialty. Unfortunately, sometimes, these billing codes are not legally and properly interpreted.

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