In the past, I’ve written many articles about why insureds should NOT speak with insurance companies on the phone, and for the most part I believe that the majority of people do not. However, there is still a large percentage of insureds and claimants who still believe, “If I do everything the insurance company asks for, my claim will be secure.” Unfortunately, this is not the case, but I do think I’ve done a pretty good job on this blog discouraging people from sharing their life story to an insurance company.
To begin, insurance companies recognize, as part of their denial initiatives, that there are opportunities to deny claims when speaking to claimants on the phone. You might ask yourself, what opportunities? Here are a few reasons why insurers favor speaking with YOU on the phone.
- Insureds are scared.
- They are under the influence of opiates, anti-depressants, and pain meds.
- Most are vulnerable and need money.
- People are worried about credibility, and not being believed, and OVER SPEAK their claims.
- People on claim are medically weak and can be intimidated to say and do anything because they do not have the capacity to fight back.
- Claimants will get distraught if they think claims will be denied and will give in to any demand.
- Insureds will eventually shoot themselves in the foot if you get them on the phone long enough and often enough.
- What better back-up can there be if an insurance rep can get insureds to admit to their own work capacity?
- Claims handlers can “set the tone” and insult you, or make insureds believe they are wrong about not returning to work. They can make you “feel bad” by creating a “he said, she said” conversation that can never be proved officially.
- Claimants never read their Plans or Policies and don’t realize there is no legal requirement to provide information directly on the phone.
Just the other day a gentleman called me on the Claimify issue and kept telling me how “nice, and what a good time he’d had on claim from Lincoln”. He had spoken on the phone to his insurer since the beginning and alleged it had all gone well for him. He is very lucky indeed!
I think I should be clear on one issue before continuing. Insurance companies overall pay about 50% of claims or less. That means that there are at least 50% of claims that are always on the right desk, at the right time, with the right person and manager, and experience no claims issues at all. Occasionally, I hear from these people and I’m really happy that is the case for them.
However, the other 50% of insureds are having terrible times with their claims and need to be careful that the wrong manager, at the wrong profitability time, will target their claims and demand claims handlers follow that same Primary Plan Direction. If you’re not one of the lucky 50%, then you are, or will be, one of the denied, unhappy 50%.
Claims handlers are schooled about phone interviews and are provided with “template lists” of “update questions” that may seem innocent enough. Insureds who take insurance phone calls are victimized by skillful claims reps who know how to get people to say incriminating things. A good example is that several years ago,
I saw quite a few claim denials because insureds shared (on the phone) that they babysat their grandchildren. This one statement caused quite a few denials.
Bottom line, insureds should NOT speak with insurance reps on the phone. It is a “stack the deck” risk management activity with a clearly defined agenda to deny claims based on the information obtained. I’m asking my readers to over over the above list again, and think about why speaking on the phone with an insurance company is not a good idea.
