Claims Handlers Are NOT Your Friends And Other Nonsense

FriendIn some respects I hesitated to write this article for fear that someone would think I’m making fun. In my mind the subject is much more serious, so I’m writing about it anyway.

I received a phone call this week from someone who told me, “I don’t want to make my Unum claims handler angry at me. We’ve become friends and I wouldn’t want her to get mad and deny my claim.”

“Oh boy, here we go again”, I thought. “Another insured, persuaded into thinking a Unum claims handler (or any claims specialist) is a friend.” What I usually do in these situations is ask the insured to sit quietly for a moment and consider logically under what circumstances an insurance company who makes money from NOT paying claims could ever be characterized as “a friend.”

To make matters worse, this particular insured actually called because her “friend” at Unum is now asking she submit to a Field Visit. Some friend……

All claims handlers are trained to some extent in “playing the part.” But, in reality, most employees who touch claims are actually hired only if they are determined to be “A” type personalities who, according to one of my old managers, “won’t give away the farm.”

In addition, insureds are unaware of what’s happening behind the scenes to deny claims, regardless of what’s taking place on the telephone. This insured also told me she had not obtained a copy of her policy, nor had she read it. I asked her, “Well, how do you know you have to do a field interview?” She answered, “Because Unum cited my policy in the letter and told me I had to.” Oh boy, oh boy, oh boy………..

And, by the way, many people tell me, “I don’t want to make Unum mad at me.” Really? Unum isn’t human, it’s a corporation and can’t get mad at anyone. Even Unum can’t deny claims because it’s mad, and neither can claims handlers, who actually ARE human.

Finally, this same insured told me, “I read on your Blog that you don’t recommend using any of the website portals, but I’m going to use it anyway. I don’t want to cause any problems.”

I have to admit I don’t understand the logic of doing something you know is not in your own best interests, like speaking to an insurance rep on the phone. But, as I am frequently known to say, ” I can only tell you what I think is a “best practice”, and you will either do it, or not. The result may be that you fall into a black hole that you can or cannot pull yourself out of.” Not listening to those who know can be costly.

However, this notion that insurance reps are “friends” has got to go. Unum’s (and other insurers’) specialists are paid to deny claims, not pay them, mind you, but deny them. That doesn’t sound very friendly to me.

I also know some insureds try to “sweet talk” their way into a claim approval by sharing every family, claim, health, life, and childhood detail they can. This tactic will certainly come back to bite you.

And finally, you can’t make a sterile business entity “mad at you.” Best advice is to think logically about your relationship to the insurer which is only represented in your Plan or policy contract. This is why it is so important to read your policy and understand it.

And if what you’re thinking doesn’t make sense, it probably isn’t in your best interests. Claims handlers just want you to be cooperative so eventually you say something that can be used against you.

Of course this makes more sense than thinking Unum’s reps are your “friends.” I’d be very careful about trying to shake hands with the hyenas.