Insurers’ end-of-the-year claim denials are in full swing, and desvastating to those who have no financial assistance for the holidays. Reasons for the denials appear to be first and foremost “not persuasive medical information”, or mental and nervous therapists and treating physicians throwing claimants/insureds under the bus with unexpected doc-to-doc calls.
In the last six months I’ve written more than one article describing changes insurers have made to their claims investigation procedures. In addition, although I’ve also written many good articles on medical requirements needed in order to support disability claims I notice the “read” numbers are relatively low for those posts.
While the changes made internally by insurers to strike down claims were probably not made specifically for year-end, the 4th Quarter battle for profitability in 2019 is likely to be a nasty one. Inadequate medical support for claims written by treating physicians who barely take five minutes to write anything down will cost claimants/insureds millions in much needed future benefits particularly over the holidays.
A large percentage of treating physicians have “lost heart” and willingness to continue to support disability when insurers kick their recommendations to the curb. But by-and-large, treating physicians are far too busy these days to document medical or mental disability, and some are refusing disability patients on that basis.
To be honest, I wish I had the time to write a reference guide for physicians and therapists, in fact, I may over the holidays put something together for my clients’ physicians as a reference.
But make no mistake…….I am not exaggerating when I say that insurers are now requiring a higher burden of proof, not contractual mind you, but a burden that treating physicians are finding it hard to meet. And, the situation is not going to change.
The more physicians move away from disability patients, the more insurers will tighten the noose.