Disability Insurance Claim Advice

Why you need a disability consultant

In today's disability claim environment... an insurance company doesn't have to commit physical murder to accomplish their goals. Instead they create an atmosphere in which the policyholder (claimant) is reduced to economic and/or emotional suicide. When pushed to the extreme... paresthesia sets in and the claimant resembles a jellyfish... floating in the sea of vast darkness. Not all insurance companies are guilty as charged. Some actually, by their actions, make an effort to be honorable and treat their insured with respect, but their numbers these days seem few and far between. What are the insurance company's weapons?

VIDEO SURVEILLANCE
They will videotape you to create a scenario of embarrassment and use as a threat against you. Even with your bad lower back and/or cervical problem you rightly feel a need to get out of your jellyfish position and get some exercise. You play golf and even your doctor will tell you the exercise is good for you. And if the pain comes or gets worse... you walk off the course and go back another time. However, when you are performing surgery and the pain comes on or exasperates your symptoms, you can't walk away from that scene so easily.

PAPERWORK
The amount and depth of forms that you are requested to complete is overwhelming. How did you spend your day in the past (Prior to disability.) How do you spend your day now? Describe your disability in detail. The questions go on and on and on... like the constant flow of the ocean waves. Send us your corporate and personal tax returns for the past five years. Send us copies of your patient calendar for the past six or twelve months. Send us this... send us that. It seems like a never ending trail of paper and they keep on coming back for more.

INVESTIGATION
People call you on the telephone to ask more questions. People come to see you either unannounced or by appointment and ask still more questions. Sometimes they ask you to sign a statement they have completed at your meeting with what they purport to be the "facts" of your claim. Do you sign... do you weep... do you say no? Countless questions.. but do you have all the answers... the correct one? And even after you have sent in all the financials, they may be scrutinized by a C.P.A. representative hired by the insurance company to make sure you and/or your accountant weren't too creative in computing the figures. And if you have a partial (residual) claim which involves a loss of earnings, the subterfuge they have created by this ambiguous policy language to further reduce the monthly benefit, will create further anxiety on your part. There are home office physicians, nurses, rehab people, ergonomic people, and any one of a number of soldiers ready and willing to do further battle with you. The privacy and dignity that were once a part of your life have withered away.

I.M.E. (INDEPENDENT MEDICAL EVALUATION)
After you have provided all the appropriate medical information including copies of every paper and notes that your past and current attending physicians have in their files, they will want more... because they still don't believe you. So they bring out the biggest weapon of all... the I.M.E. Sometimes they produce their I.M.E. earlier in the battle... sometimes later... but it seems never-ending. Even if the biggest name doctors in the world have attested to your current disability, or you have been on claim for the past five years... the I.M.E. may surface. And, hopefully, your claim won't be related to depression or stress, since that will typically involve a double whammy... a visit often to both a psychiatrist and a psychologist. And they will ask you every question possible since the day you were born and create a mound of paper the likes of which you could never dream possible.

CHANGING OF THE RULES
Assume you were a surgeon when you purchased your disability policy and continue in this fashion just prior to disability. At the time of purchase... your broker or agent said... if you can't do surgery, but you can do office exams related to your specialty ... the insurance company will consider you to be totally disabled. Now you have a cervical or low back problem, or both, and you can't perform surgery safely. The insurance company says YES... you are disabled partially... but not totally, and if your earnings are reduced by a certain percentage, we will pay you some money but not for your lifetime... to age 65 only. And that's assuming they didn't throw in limited wording whereby they may say you have to be totally disabled FIRST (for at least the waiting period) before they will consider paying you under a partial (residual) claim. Thus... what they (the insurance company) meant when you were sold the policy may not be the same when it came time to pay you under a claim. These rules change based upon interest rates, overhead expenses, insurance rating organization opinion, the stock market and a host of other factors that might enter into the equation.

THE BUYOUT
Now that the insurance company has weakened you to the point of mental exhaustion... they come in for the kill. It is a financial advantage to them to eliminate the reserves they have set up to satisfy the requirements of the insurance department of your state. So they put out a ''feeler" to see if you will surrender your disability policy... and your claim... and give you a check for $.10 on the dollar. And that's if they feel there is merit in your claim. If your claim isn't "perfect"... a termination letter may be more the order of the day.

WHAT ARE YOUR WEAPONS?
The best weapons that you can possibly have are your integrity and your credibility. Add to that an individual that can guide you through every step of the claim process and help you to get past the "land mines." Someone to lean on when you feel you can no longer stand up to Goliath... that large insulated multibillion dollar faceless corporation that wants to murder you by proxy. Whether you have a new problem or terminated claim, a disability claim consultant can provide help in areas where you do not have expertise and can help you provide clarification of your claim for the insurance company. In the worst case scenario, the consultant can provide backup or recommend an attorney with experience in dealing with disability claims should legal recourse be necessary. And even if you have made mistakes, you may be able to correct these mistakes with the proper help and guidance of the DISABILITY CLAIM CONSULTANT.