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What Is Reasonable Or Appropriate Medical Care To The Insurance Company?

What is “reasonable" or "appropriate" medical care according to the insurance company? I will not allow their specialists to conduct TMS or ECT due to the risks, i.e. seizure, heart attack, stroke, death, further memory or cognitive difficulties, etc. Is it my choice to decide what is reasonable or do I have to accept the specialist’s recommendations?

Long Term Disability - Question 2
It is difficult to define with precision what constitutes “reasonable” or “appropriate” medical care. Both TMS and ECT are not without their detractors and any insurer that cuts-off benefits solely on the basis of a claimant’s decision to seek alternative treatments should proceed with caution. That being said, the insurance company may take a refusal to undergo treatment as a basis for terminating disability benefits.  If benefits are terminated as a result of a claimant’s refusal to undergo treatment being recommended by his or her specialist, legal advice should be obtained to determine the chances of success in proceeding with legal action.

 

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Ask Share Lawyers

This searchable database contains information about disability, critical illness and life insurance claims, and what you can do if you are denied or cut off of your benefits. It is a collection of the most common questions we receive from our clients. General answers have been provided by our lawyers.