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Don’t Make This Mistake With Your Insurance Company From the Beginning

8 Jun 2020

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.

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Brandon and his team at Osterbind Law are truly peerless. This is exactly how a modern personal injury firm should operate. The firm is holistic in its approach and thoughtful. It's no wonder why they get such great results for their clients. And no surprise, their clients love them. I've had the pleasure of working with Brandon on a professional level and he levels up, big time. Kudos.
Nathaniel Amendola
3 months ago

Very compassionate and knowledgeable people who helped us with our situation. They worked quickly and I can’t tell you how grateful I’m they were so caring. I would recommend this firm to anyone that anyone
Lori Rudder
a year ago

The entire team at Osterbind Law are incredible. They communicated with us with every step and process that was happening . They provided the knowledge, support, and empathy to us on the case. And when the curve ball was thrown, they dug in deeper. I have nothing but the highest respect for Brandon and Hannah and the entire team. They made us feel more like a family, than a client.
Wendy Shull
a year ago

The staff is caring and very knowledgeable. They help you as quickly as possible, and worked very hard for us. I'm so pleased with the way they assisted us.
Meghan Rudder
a year ago

Brandon and his team did a great job helping me through my case. I'm so glad I chose him and stuck with him through the transition to his own firm. The staff is very knowledgeable and friendly. They feel like family after all this! Thank you for everything!!Amber J
Amber Higby
2 year ago
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