Disability Claims Solutions, Inc. provides insureds across the USA with resources to make better decisions concerning ERISA Group STD/LTD claims, as well as Individual Disability Income benefits and Long-Term Care. Having the opportunity to work with an expert consultant, such as Linda Nee, provides insureds with valuable procedural options to work through problematic issues in successful ways.
Our focus is to resolve problems, not wrestle with conflict. Call Linda Today!

Disability Claims Solutions

Disability Claims Solutions, Inc. provides insureds across the USA with resources to make better decisions concerning ERISA Group STD/LTD claims, as well as Individual Disability Income benefits and Long-Term Care. Having the opportunity to work with an expert consultant, such as Linda Nee, provides insureds with valuable procedural options to work through problematic issues in successful ways.
Our focus is to resolve problems, not wrestle with conflict. Call Linda Today!

Remembering Tricks Of The Trade

I had a telephone call the other day that quickly reminded me of old times and some of the credibility tricks claims handlers use to catch insureds in untruths or exaggerations. One of the biggest mistakes insureds can make is underestimating the ingenuity of the people who are trying to harm them.

Claims handlers receive phone calls from many different types of insureds. What I’m about to describe is something I call the “feeble-voiced insured.” Claims handlers are well aware of the deception and document it in the file for management and other reviewers to see.

Claims handlers place phone calls to insureds without identifying who they are. Claimants answer the phones and speak in normal voices in an every day normal way. However, several hours later, claims handlers call the same insureds again and identify themselves. This time, insureds vocalize themselves using a low, sickly, feeble voice, sounding near collapse. These incidents are documented and used eventually to discredit claims. This just happened to me the other day.

I think it goes without saying that insureds should always speak in their normal voices and not attempt to sound feeble and sickly on purpose. I’m not trying to insult anyone here, just describing some of the things that go on in the course of managing disability claims.

Insurance companies are not beyond trickery particularly during surveillance or field home visits. In the past, field investigators, including the one who trained me, described situations where Unum field agents would ask insureds for a glass of water to see if the person actually used the cane leaning up against the table. Most insureds would walk to their sink to get the water, forgetting the cane placed nearby.

Likewise, insureds disabled due to cognitive problems were always asked to count the change in the field investigators pockets. If they counted accurately, insureds were NOT considered cognitively impaired.

One of the reasons why I do not recommend speaking with claims handlers on the phone is this particular example. While still a claims specialist I suspected an insured received an SSDI award and overpayment and didn’t report it. I called the woman and asked about it at which point she completely denied getting any money. “Oh no, she said, you’re wrong, I didn’t get any SSDI or overpayment.”

“But”, I said, “I have a letter here saying that you received $850 in benefits.”

“NO”, she screamed into the phone, “it wasn’t that much!”

Oops. Anytime insureds risk speaking on the phone, there is an opportunity for any insurance company to employ some sort of deception to attempt to learn the truth. Insurance physicians use these types of tricks to harass treating physicians into agreeing with their agenda that insureds can work. If insureds and their physicians are unaware of possible deceptions, insureds can clearly get taken to the cleaners, and they do.

There is. no end to the number of tricks insurance companies can use to, in their view, obtain the truth from those who, also in their view, just want to get paid. Be careful here….and watch what you say.

 

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