The insurance industry has always been a “paper” dedicated rule book beginning with state regulators and moving down to individual companies. There are often more “forms” required than needed, making the entire claims process an administrative nightmare.
Included among the most tedious of insurance requests is the infamous “Questionnaire” that, at first appears innocent enough, but can actually cause the denial of claims when insureds are not careful when filling them out. Unforunately, most insureds’ first instincts is to complete the questionnaires giving as much detail as possible, often reducing the size of their handwriting, “to fit it all in.”
This is certainly one of the major mistakes any claimant can make when attempting to complete insurance Questiionnaires. The design of an insurance questionnaire is deliberate. Make no mistake, these Questionnaires are not innocent updates, but rather are designed to solicit “activity” information from insureds that can be used to either conduct surveillance, or use as backup for work capacity.
I’ve written many blog articles about equating questionnaire responses with METS and work capacity. However, insurers can’t do that when insureds restrict their truthful responses to simple “facts” rather than “details”. Think about this for just a moment. DETAILS = red flags that provide information that can be used against you. To be clear, DCS always recommends truthful answers be given on quesionnaires, just don’t give away the farm along with them.
For example, the infamous question on most Questionnaires, “Describe a typical day…” Most insureds will do just that, “I get up, have my organge juice, get on the computer…rattle, rattle, rattle,” and then several paragraphs later end with, “I go to be bed after the news.” There are so many details in an answer like that, such as looking at computer emails, doing laundry etc., that can actually be responsible for denied claims. Completely unnecessary.
I would be willing to say that no one, healthy or not, has a “typical” day. So why not say so? “My day varies in accordance with changing levels of fatigue, pain [whatever your symptoms are], and no two days are ever the same.” This answer is devoid of details the insurance company is looking for, but I’d say it is a very truthful answer more so than any other. No one has typical days, so it’s not necessary to pretend you have them.
The next question is usually the same question put another way, “What activities have you tried to do and what progress have you made?” The answer should be obviously simple, such as, “I continue to abe able to engage in many activities, and no progress has been made.” It’s OK to call, a thing, a thing.
Companies such as The Hartford and The Standard have ungodly long Questionnaires containing questions that go on and on about the same subject, “How many naps do you take each day?”, and “When you nap how how long do you sleep?”, and on and on. The detail these companies are asking for is ridiculous, “Do you visit friends?”, “How long are your visits?”, I’m sure you get the point. The litany of questions is to solicit information that can be used against you in conjunction with surveillance.
Many phone conversation interviews now ask the question, “How often do you have sex?” No insured should answer questions like this; it’s none of their business. The intent of the question is again looking for “work capacity”, which would be funny except that the question isn’t relevent to the issue of disability, Plans or policies. And, it’s certainly not funny to the person thinking they have to answer it. Don’t answer questions like this, it demeans “disabled persons.”
Therefore, consider “less is more” when it comes to filling out Questionnaires. Don’t give away your claim with unnecessary detail. Be smart, and get help when you need it.