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Understand your insurance contract, document medical care and treatment

"It all boils down to what the policy says."

That's how Arthur L. Fries sums up what dentists need to know about receiving disability insurance benefits. The registered health underwriter has been helping physicians, dentists and other professionals file claims for some 13 years.

"I help people understand what their policies say," says Mr. Fries. "A lot of problems occur because dentists don't know much about their policies and don't know how to correctly fill out claim forms."

Provisions such as "Under a physician's care," or "Under a physician's care appropriate to the condition" can make an important difference, he says. "Improper medical documentation overall can really be a problem."

Gina Goodreau, senior manager of ADA Insurance Plans, agrees.

She says, "A claimant who understands his or her contract can mitigate loss and better navigate the claim process. For example, mediocre medical documentation coupled with a weak or nonexistent treatment plan can result in claim delays and an independent medical examination (a chart review and examination by a physician chosen by the insurance company)."

Useful contract definitions under the ADA Disability Income Plan are available online at www.insurance.ada.org.