Since we are coming up on end-of-the-year profitability targeting, I am once again reminding everyone of a few basic “best practice” rules when it comes to filling out insurance Questionnaires. Your responses could mean the difference between a paid claim, or a denied one.
When asked, most insureds try to tell the insurance company the story of their lives on most forms, narratives and questionnaires. Instead of just answering the question, insureds elaborate on their conditions to the point that they have to decrease the size of their printing to fit it all in the space provided. Over the years I’ve repeated myself on many occasions: INSURANCE COMPANIES CANNOT HOLD AGAINST YOU WHAT YOU DO NOT SAY.
First, let’s deal with the motives of insurance companies and why they ask the questions they ask. The intent is to ask leading questions they know insureds have a tendency to OVER SPEAK so that “activity” information can be obtained, and used as back-up to deny claims. Insurance companies are well versed in the psychology that pushes insureds to give more information about themselves in order to justify their claims. They do the same thing with phone interviews, which is why DCS always recommends communications in writing only.
Believe me when I tell you that “laying it all out on the line” and giving as much information then needed is NOT the way to secure the safety of a disability claim. In fact, giving more information to defend one’s claim is one of the worse things any insured can do.
The example I usually use is that infamous, over asked question we see everywhere: “Describe a typical day for you listing your activities”, or, something to that effect. So, most people would start like this; in the morning, “I get up have my orange juice, check emails, go back to bed, get up, walk my dog etc., you get the picture. Two pages, or a half an hour later the answer ends with, “I go to bed after the news.” This is the worse possible answer any insured can give because all the “activity” information is used for future surveillance, and work capacity. It’s way too much information.
Another question would be: “Describe your restrictions and limitations.” R&Ls are medically related and should be left to the most qualified source to provide, namely your treating physician. I always recommend deferring that question “to the file”, or “to my treating physician.”
End of the year questionnaires are send out at year end to target activity suggestive of work capacity, and insureds need to pay attention to their answers. There are basically three recommended answers that protect the insureds’ interests. 1) Give a generic answer. 2) Don’t give details, and 3) Always answer the question only. Don’t elaborate.
Let me be clear here. Insureds should always be TRUTHFUL with their answers. But, everything with insurance has to do with “how you position things”, and insureds can certainly do that. It’s important for insureds to have a really good sense of how to write the truth, answering only the question, and positioning the answer in their favor.
Please keep all of this in mind as we approach end-of-the-year results. If you need help with this, please let me know.
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