Most of the information on the Internet pertaining to disability claims management is negative and discouraging. However, today I’d like to write about some of the positive reinforcement actions insureds can put in place to help themselves have a better time while on claim.
Know your policy or Plan. Every insured and claimant should have a copy of their policy or Plan and a clear understanding as to what their obligations are, and what insurers are required to do. Insureds often misunderstand certain provisions written in the contract and therefore it is important to contact someone who can explain in detail what specific provisions mean. Insureds who attempt to “fight” policy or Plan provisions based on false premises will, of course, lose their arguments. Therefore, it is very important to obtain copies of policies and contracts and be familiar with the provisions.
Improve your attitude and perspective. Insurance companies have terrible reputations when it comes to reviewing and paying claims. Public perception of “deny deny, deny…” causes insureds a great deal of angst when it’s time to file claims. Every one on the Internet seems to have a sad story, and in addition, opinions of family, friends, and often many attorneys, reinforces how “the big bad insurance company is going to get you.”
While I am a firm supporter that “attitude” in life determines our paths, it is particularly important for insureds to adopt an attitude toward filing claims that is positive rather than negative. To be sure, disability insurers “risk manage” everything and tend to deliberately deny claims. But, yours doesn’t have to be one of them.
It is far better to enter into the claims process with an attitude that you will take all of the necessary steps to enforce the provisions in your particular policy or Plan in a professional and businesslike manner.
Be prepared to defend your policy or Plan. There are basically two types of negative attitudes towards claims that are defeating: 1) the insured who enters the process angry, frustrated and certain the insurance company is out to get them, and 2) insureds who are willing to do any and everything their insurers want them to do, thinking their claims will be paid forever. Both attitudes are equally destructive. Therefore, the first thing insureds can do towards claims management that is positive is to enter the process prepared to support claims in accordance with policy and Plan provisions.
Develop skills in reading insurance communications. Most insurance communications are templates adopted by management that are supposed to be “tweaked” by the claims handlers to individualize to each insured. Some claims handlers are better than others in doing this, but insureds can come out ahead if only the “requests” sections of letter communications can be identified. There is no point in worrying about an 8 page letter when 7 pages are nothing more that repetitious citations of policy provisions.
It is very important for all insureds to adopt positive attitudes about their claims and work toward success rather than saying to yourself, “they all deny claims and I don’t have a chance”, which isn’t helpful at all. As a Consultant, I prefer to avoid conflicts and instead resolve the issues. While disability insurers still engage in unfair claims practices, managing claims positively provides more solutions than not.
