Facts and Findings
Disability Insurance Claim Advice
How do you think your disability claim will be handled?
- You will complete and submit whatever claim forms are provided to you by the insurance company.
- You will give your attending physician(s) forms to complete and return them to the insurance company.
- You will expect to receive a monthly check in timely fashion for the duration of your claim.
What is reality?
- Most claimants, after completing their claim forms, will immediately and unknowingly prejudice their rights.
- Most attending physicians, even with the best of intentions, also will prejudice your rights . . . and won't even know it.Most attending physicians have never been educated about the difference between a Workers' Compensation claim response and that of an individual or group disability claim.
- You may be requested to have an IME (independent medical evaluation). This type of exam might last for an hour or three or more. How should you conduct yourself at this exam? What should you bring with you? Will the examiner, hired and paid for by the insurance company, be as objective as you might wish? Will he/she be fair? Is there anything you can do when the physician conducting the exam says: "There are no objective findings"?
- You may be asked to provide a list of your pre-disability duties and hours compared with your post-disability duties and hours. That is, what you did prior to disability and what you are doing now. This is one area that can make or break your claim.
- The insurance company pays you for five months and then stops. What are your rights? What should you do? Roll over and play dead, consult a consultant, or consult an attorney?
- Objective vs. subjective symptoms. Can the pain be measured or is it related to what you tell someone? Example: You tell your physician you feel nauseous. That's subjective. You throw up in front of your physician. That's objective. Do different insurance companies have different attitudes in this area? Can you do something to help your claim?
- A buyout! A person representing the insurance company comes to your door, often unannounced, "dangling" a check in front of you. Should you grab the bait or just mouth it with the option of spitting it out? Should you accept this check and give up your claim, as well as your insurance policy? If you don't accept, should you accept it in round two, in round three?
- And, how much should you accept should a buyout appeal to you? Do you know what key advantage there is for the insurance company if you should accept?
