There are still many insureds who choose to speak to insurance companies on the phone even when doing so is not an insurance claim best practice.
Today, for some reason, insureds and claimants seem to “believe” exactly what they are told by insurers even when they are aware of the conflict of interest, namely, that insurers are both reviewers and payers of claims. Even in an environment where a large majority of claims handlers can’t speak good English, it is possible to be duped by a claims handler seeking information to use to deny your claim.
Insurance companies are paranoid about two things – 1) insureds are working and not claiming the income, and, 2) claimants are receiving SSDI and haven’t told anyone. Because an insurance company is “an arm’s length away” from information they need, it is constantly seeking data from you. If they don’t get the data they need, they become paranoid.
As a result, a phone call is typically made to obtain what you think is a update, but the conversation also has an agenda of its own. Official phone calls from insurance companies are planned, programmed, and potentially harmful. Most insurance companies have distributed “templates” to be used as guidelines for questions that have nothing to do with disability claims. Let’s be honest – the obvious intent of a phone conversation is to prompt insureds on the phone to provide information that can be used against them.
What insureds often do not realize is that there is no disability on this planet that requires phone calls as “proof of claim”. Plans and policies DO NOT REQUIRE ANYONE TO SPEAK WITH INSURERS ON THE PHONE. Insureds ARE required to provide continued proof of claim when requested to do so, but may do that in any way they see fit. Any insurance company that tells you you HAVE to speak to them on the phone should be asked to provide you with the page from your Plan or policy that requires you to do so. Hint: it doesn’t exist.
Whether insureds are aware, or not aware, of the insurance agenda, some still think nothing of picking up the phone, calling the claims handler, and sharing far more information than they should. I call this OVER SPEAKING your claim. If you know the insurance companys’ interests conflict with your interests, why would you go ahead and share information you know could be used against you? It defies logic to me, and it risks claims.
Here are a few myths commonly believed by insureds that often put their claims in jeopardy.
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- Insureds think that if they do not share every little detail about their claims, the insurance company won’t pay them. In reality, it’s exactly the opposite; insureds create “red flags” by volunteering information over and above that required to have a disability claim.
- Insureds may believe that advertised “claim best practices” are all a bunch of bunk, and after all, insurers really aren’t all that bad, and aren’t trying to deny them.
- Insureds OVER SPEAK their claims because they think it makes claims seem more credible. Wrong. Nothing you actually say is documented like you say it, so how credible can that be?
- Insureds think if they don’t do every thing their insurers ask of them, it will be “mad at them” and deny their claims.
- If I don’t speak with my insurer on the phone, it makes me look bad.”
- Insureds tend to trust themselves to speak with insurance companies even when they are taking opiate, pain or depression medications that could distort what they say.
These are just a few “bad habits” that insureds tend to believe without question. Let me remind you that insurers are seeking information about you, and they do not distinguish between what is needed to pay claims versus what is needed to challenge your credibility.
What I would like to leave you with in this article is this: AN INSURANCE COMPANY CANNOT HOLD AGAINST YOU WHAT YOU DO NOT SAY (OR WRITE). Do not be so anxious to talk, and talk, and talk on the phone with any insurance company. Only send written communications and if possible, stay off of the website portals.
On those occasions when insureds ignore “best practice recommendations”, claims decisions don’t usually turn out well for them. Claims handlers are definitely NOT sharing the whole story with you, so it’s a good claims practice NOT to speak with any claims handler on the phone. Protect yourself and listen to the people who know.
