Disability Claims Solutions

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What Am I doing wrong?There are literally thousands of disabled insureds who wake up each morning with stress pains in the pit of their stomachs. The uncomfortableness continues the entire day,  reaching a crescendo in late afternoon until the insured either picks up the phone to reach the claims rep for assurance, or logs into a website surveillance portal. This is the only way insureds can feel peace, but alas, peace of mind is only short-lived for the disabled with a claim.

Although insureds spend the entire day thinking about benefit checks, claims, and health, it becomes normal and customary to do so; and within a short period of time, feeling stressed and fearful becomes the norm – day after day after day.

The day benefits are due to arrive, insureds wait nervously, checking online accounts every hour, or sit not-so -patiently waiting for the mail. Anxiety begins to build up a week before money is expected with countless sleepless nights wondering if benefit checks will arrive or not.

Finally, the day comes and when the check arrives, everyone takes a deep sigh of relief, but only for two weeks until the dread and nervousness begins all over again. The constant worry of receiving money never seems to end as insureds continue on the merry-go-round of stress and anxiety, intermixed with brief periods of peace, followed by more stress and anxiety.

People who call DCS often ask me “What am I doing wrong?” “Why does the insurance company keep me on the edge of my seat always looking for a benefit check? “What the hell am I doing wrong?

Trying to manage a disability claim without the Plan or policy.

I am always surprised by the number of claimants/insureds who file and manage claims without copies of their Plans or policies. This is like trying to play cribbage when no one has explained the rules to you. It’s not even like Monopoly where you can pretty much figure it out by yourself, eventually. Managing a disability claim requires insureds to have a complete understanding of what the document says, and understand everything that’s in it.

Managing disability claims from a position of fear.

Claimants/Insureds may find themselves in positions where they have no other sources of income except disability benefits. One of my old college finance instructors used to say, “Any one or any entity that controls your money also controls you.” Think about that. Doesn’t the disability insurer control your money, claims, what you say, and what you do even when you know it is unreasonable?

Thinking that if you only provide the insurance company with the story of your life and everything they ask for, you will continue to receive your benefits is one of the worst mistakes insureds make. Feeling the need to “defend” claims, insureds also make the mistake of talking, and talking, and talking, providing more ammunition that can be used against them by the minute.

OVER SPEAKING claims.

Insureds will often tell insurance companies, field reps and IME physicians anything if they think it means getting the next benefit check. Insurers are entitled to information concerning their medical information, occupation, and sources of income. Where in the Plans and policies does it say you have to “Describe a typical day?”, in detail mind you. Or, where in the documents does it say you have to submit “objective evidence” as proof of claim?

I can’t tell you how many completed update forms I’ve reviewed where insureds have actually reduced their “printing” to less than 1/8″ in order to “get in” all of the information. Update forms are not intended to be detailed and if there isn’t enough room to write everything, then you are disclosing way too much information.

Using “stories” and “tales” from the Internet as guidelines to manage claims by.

In my opinion, the Internet is a glorified National Enquirer. Every one has a sorry story to tell. “Well, I have a friend, of a friend who used to work with a friend who told me my employer…….”, or, “I looked it up on the Internet and this happened to a person’s claim”. All disability claims and policies are different from each other. Making the mistake of believing a sad story from the Internet and applying it to your own claim can turn out to be very costly. Every claim circumstances is different.

Not listening to the people who know.

Sometimes when people call me on the phone to ask questions I give them best practice advice on how to solve their claims issues. What follows next is 10-15 minutes of callers telling me why they can’t, or won’t do it. From my perspective I just spent 10-15 minutes of my time I can’t get back.

Disability insurance is specific, detailed, deliberately pre-determined, risk managed with deceptively employed strategies, and the odds of getting an approved claim are less than 50%. This doesn’t make sense to me. Insureds are stressed out and fearful of not getting paid and yet they are often reluctant to listen to the people who know. It doesn’t make sense.


By far, these are the top things insureds do wrong in trying to manage their own claims. Insureds may find themselves on the wrong side of a Texas Hold’em card table in 2020 when the “new normal” procedures kick in. Insureds will need to be smarter and wiser in 2020.