One of the most ridiculous and seemingly unfair tactics of insurance companies is to ask insureds:”Since you have been working with restrictions and limitations in the past, what changed?” The allegation has been used and documented for 25 years with little success by all insurers.
The presumption here made by the insurance company is that if an insured can continue working with his/her impairment, why is he applying for disability now when he could still work.” In other words, the insurance company is using the “what changed?” defense to say that you have work capacity. Then, the claim is denied.
I have not seen this out of date allegation made for over 10 years. But, here we are, new environment, old unfair claims tactics cropping up again.
The “what changed defense” is recognized as a “stupid question”, and all insurers know the answer before they ask the question. Nearly 80% of all disabled persons attempt to remain at their jobs, for financial reasons, if nothing else, until a worsening mental or physical disability makes it impossible to continue to do their job. Then, they file for disability.
Therefore, the answer to “what changed” should be a written response documenting the worsening of the insured’s condition and calling out the inappropriateness of the question in the first place.
Please also be aware that insurance companies often send the “what changed defense” to treating physicians who are unaware of the maliciousness of the question. This is why it is always a good idea to ask treating physicians to provide you with a copy of every communication the office receives about you from an insurance company.
Prudential seems to be one of the many culprits recently using the “what changed defense” as an excuse to deny claims. This is an unfair allegation that insureds need to immediately address in writing and get it into the file. Every one in the industry knows why the question is asked and how they use their own presumptions to deny claims.
I really hope that insureds are finding their way to my Blog and are taking the information I’m writing about seriously. You’ve probably read that we are now in an entirely different environment for disability claims review. If you need help along the way, don’t assume you can “take care of the problem yourself.” I know as soon as I write this, I’ll get emails from people telling me, “I took care of it myself.”
But, that won’t be the case for the majority of insureds and their doctors who fail to recognize the underhanded intent of asking, “what changed?”
If you see the “what changed” defense in your letters, it should be a cue to you that your insurer is getting ready to deny your claim. Your rebuttal as I described it above, along with as many patient notes you can submit to support the worsening of your condition, is the way to deal with it.
Also, please help me get the word out to other insureds who should also be made aware of the information located here. Thank you.
My website is located at: http://wwwdisabilityclaimssolutions.com
Email: DCS@metrocast.net
