Don’t Make This Mistake With Your Insurance Company From The Beginning
My name is Brandon Osterbind. I’m an injury and disability attorney in Central Virginia and I help people whose long-term disability claims have been denied.
There are several mistakes you can make with respect to your long-term disability claim, but today, I want to focus on a mistake that a lot of people make from the very beginning.
They misjudge the relationship between themselves and the insurance company
The number one mistake that I think that people make is that they misjudge the relationship between themselves and the insurance company that is responsible for awarding their long-term disability claims. And I’ll say a couple things about that.
First, the insurance company is essentially filling the role of your employer and as an agent of your employer, who has a fiduciary duty to you. They have a duty to look out for your best interest.
They look for reasons to deny your claim
And the insurance companies often don’t do that. A lot of times, they’re looking for reasons to deny your claim. It’s important to have a good relationship with the claims manager or the claims specialist who is working on your case from the very beginning.
Your relationship with the claims specialist
But it’s also important to view that person with some skepticism. Don’t give too much information but also don’t be too tight-lipped when you first talk with the claims specialist because that person is going to administer your claim. They’re going to look for medical evidence.
They’re probably going to talk to your doctors. They’re probably going to hire doctors to review your medical records. And they’re probably going to do a lot of things that you weren’t even aware of.
I think it’s important to have a good working relationship with the claims specialist and to get your information to the claims specialist as fast as you can. But you also have to understand that the claims specialist is not going to be looking for ways to approve your claim. That person is going to be looking for ways to deny your claim.
How to talk to your claims adjustor
As you’re getting the information that the claims person asks you for, make sure to ask, “Is there anything else that I can provide for you? Is there anything else that you think is missing? Is there anything else that you feel like you need?” And make sure that you do that both orally and in writing.
Because the claims specialist will go from your conversation. They will key in all the information from that phone call into their own system. But a lot of times, that information is not verifiable.
I’ve had people come to me and say, “I had this conversation with the adjustor and what he wrote is completely wrong compared to what I told him.” But the problem is we don’t have any written evidence to confirm or deny that what our client said was true.
Create written evidence
And that would be strong evidence if you told the adjustor one thing and what he wrote down in the claim notes was a completely different thing. I think it’s important to make sure that you are working together with your claims specialist to get your claim approved.
But at the same time, you should do things that will ultimately protect you on the backend. like documenting what you’ve told the claims professional or sending an email to confirm. “Hey, just to confirm our phone conversation. You asked me for A, B, and C and I provided you with A and B and I’m working on getting you C.”
That sort of thing goes a long way towards later proving to a federal district court judge that the insurance company has abused its discretion in granting or denying your benefits.
What you should do
I hope this has been helpful. I hope that you will avoid making the same mistake that a lot of people make. I hope that you create a good working relationship with your claims specialist but, at the same time, you view that person with a skeptical eye and you do everything that you need to do to make sure that your claim is approved the first time, without an appeal.
If you have any questions about the information that a claims adjustor is asking you for or information that you can give above and beyond what the claims person has asked you for, give us a call. We’d be happy to sit down and talk to you and strategize with you about your case to make sure that your claim is approved the first time.
