Disability Claims Solutions

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Several years ago, most insurers designed online “website portals” as a solution to communicating with insureds by email/onliine while exercising some sort of privacy tags acceptable to HIPAA. While the idea seemed efficient at the time, website portals are now obsolete and because of COVID claims handlers have been permitted to communicate with insureds on their cell phones and by email.

Insurance investigation also uses the portals in their “risk management” schemes to follow and track the insureds use of the portals, which is then used to deny claims. In at least one denial letter I read, “…you have been documented visiting our portal several times a day and as a result, it has been determined you have work capacity.” So while your insurance company encourages you to use their portal, they also use it against you.

It didn’t take the insurance industry long to connect website portals to ways and means that can be used to deny claims. DCS, Inc. never supported website portals, but for additional reasons. Information shared on the portal may, or may not, become a part of the Administrative Record. Attorneys do not seem to be broken up about that fact, but I am. I always like to err on the side of caution with unsanitized Administrative Records rather than incomplete ones.

So, why do insureds visit insurers’ website portals everyday, sometimes up to ten times a day? And, against best advice? As far as I can determine, insureds make it a point to visit insurance portals at a minimum of once a day, maybe more, even though they know the risks. In my experienced opinion I believe people visit the portals to calm their nerves and have some peace about their claims.

From what I have learned from insureds over a period of 25 years is that once benefit checks are received, day by day anxiety and tensions about “there being something wrong with the claim”, or, “did they put a request or denial letter on the  portal” builds up over the next days to the “point of not being able to stand it.” Once insured see that there is nothing there, the anxiety level calms right down and insureds feel better.

The cycle begins again, however, after a few days and when the anxiety level builds up, insureds invariably run back to the portal – just to check. “OK, OK”, they say to themselves, “nothing’s wrong.” And, once again, everything is claim, but only for a short period of time.

My advice to insureds is to begin noticing why you’re visiting a website portal when you know it’s risky to your claim. Are you just scared or is there a valid reason? For example, I do allow  my clients to go to the portal to print out their W-2’s because getting them from insurers otherwise is always a hassle. Or, what if you lost the letter you received in the mail?

There are always good reasons to go to a website portal, but anxiety and using it to calm nerves is not of them. And, visits should be rare, not several times a day, or even once a week. I’m finding in general that people are absolutely obsessed with using technology and social media on a regular basis and feel “off” when the addiction is removed (social media in particular).

Therefore, caution should be exercised when using insurance portals. Do you really think insurers wouldn’t use these portals to risk manage claims? Think again.