Risk Management Isn’t Personal It’s Strictly Business

Sometimes I receive feedback from insureds that my posts “scare” them. Although I don’t publish to “scare”, I clearly publish to inform. This is going to one of those articles.

Unfortunately, I am coming into contact with insureds and claimants who describe emotions and “feelings” indicating the likelihood that individuals are internalizing the actions of insurers and “taking things personally.”

One insured actually described herself as “despondent”. Let’s face it, taking actions in life personally can cause a great deal of stress often resulting in surrender to whatever insurers request, even when it is in the context of out-of-contract.

Let’s be honest as well as clear. Private disability insurers will do anything they possibly can to NOT pay claims. This was true at the time you purchased (or became entitled to) your disability Plan or policy and it remains true when you eventually file a claim. I think it’s perfectly reasonable to conclude that disability insurers deliberately set the tone and context of all communications to elicit negative internalized feelings, including guilt, so that they can profit financially at your expense.

Disability insurers never consider insureds/claimants as “persons” it’s all about the financial reserve value of claims. If your benefit is $1,100/month you’re a pion; if it’s $8,000 you are a VIP and your claim is targeted for the duration. Remember, an increase in financial reserve (when you file a claim) is a loss/liability on the Balance Sheet. Conversely, a reduction in financial reserve is an immediate contribution to profit. Which one do YOU think your insurer is interested in?

Insurers basically have a one-track mind that has nothing to do with you personally. What is the purpose of surveillance? Denying your claim. What is the purpose of an IME? Denying your claim. What is the purpose of a field rep interview? Denying your claim. What is the purpose of update forms? Finding “inconsistency of report.” What’s the purpose of sending out questionnaires? To give insureds a forum to provide information giving themselves work capacity. Note: It’s never about you as person, it’s all about   money and profitability.

Still, insureds will invariably internalize actions taken and feel bad, or angry about it.

Insurers really don’t care too much about your impairment and symptoms, nor do they care how bad you “feel” about not being able to work. Companies like Unum, The Hartford, CIGNA, The Standard etc. want your claims terminated or denied and they will do everything in their power to make it happen. That’s the reality; that’s the environment your claim is in. It’s not personal, it’s strictly business.

No one is targeting you personally with surveillance, but your insurer will use your actions as justification to deny your claim. I realize there is a fine line here, but the intent is not about YOU, it’s about using you to deny your claim. Using your own words and actions to deny claims is the most persuasive way of actually do it.

To reinforce this point, go back an re-read the most recent letter you’ve received from your insurer. Is there anything about this letter that speaks to you as an individual or disabled person?

Of course not. “We are continuing to evaluate your claim and you may not meet the definition of disability”; “If you do not submit the information, benefits may be denied”; “Failure to sign this Authorization could result in the non-payment of claims; and, of course, “Failure to meet the definition of disability could result in the denial of your claim.” Is there anything about these letters that are kind, sympathetic, nice, or positive? I think not. I refer to these letters as “business threatening.”

Some insureds appear to be in shock when they see insurers acting this way, “I never thought insurance companies could do this.” “How can my insurer deny my claim when my physicians are saying I can’t work?” “The claims handler was very rude to me.” And so on. Although the first reaction of insureds is to take insurers’ actions personally, Unum’s actions, for example, should be regarded no better, or worse than, a surly Wal-Mart greeter who demands to see your sales slip before leaving the store.

My recommendations to insureds is to treat ALL actions of private disability insurers as “business transactions.” Avoid taking things personally, because it’s not about you at all – it’s about the financial value of your claim. Every action, request, risk management activity, update etc. is for the intended purpose of obtaining documentation to back up what looks like a credible denial – all of it.

I get it. “Since when is surveillance not personal?”, you might ask. Although it may “feel personal” because it is a type of invasion of privacy, insurers are really using YOUR OWN ACTIONS to deny claims, NOT YOU PERSONALLY. Self incrimination via surveillance is one of the quickest and surest ways to deny claims, which is why insurers do it so often.

Most of what happens with disability claims from an administrative perspective has to do with how insured “position responses” and develop “perceptions of what it means.” Insureds who view communications with insurers as business transactions fare much better than those who take everything personally and give in to unreasonable demands out of fear.

Dealings with a private disability insurer should always be regarded as business transactions, not personal attacks.

Michael Corleone’s statement in the film Godfather, “It’s not personal, Sonny, it’s strictly business“, is as true today as it was in The Godfather Saga, especially as it relates to private disability claim management.

If you perceive disability insurance in the context of business transactions you may save yourself a great deal of angst and frustration in the long run.