Beware the claims representative who is your buddy is the guy who holds himself out as your friend. He will tell you everything is fine and not to worry.
The claims representative will appear helpful and, at least at first, may be so. Please do not be drawn in. Do not tell personal information which is no business of the insurance company. Remember that the insurance company is seeking to accumulate information to ultimately deny benefits. Sometimes, the insurance company correctly assesses that the best way to effectuate this long-term goal is to pay benefits and act friendly and supportive. You must keep in mind that while the Claims Representative is being your buddy he is still answering all questions you might have from the insurance company’s point of view, in a way slanted in its favor. Of particular import in that last sentence is the use of the term “it.” You must keep in mind that an insurance company is a corporation which is a legal fiction created by statute. Supposedly, its sole purpose is to make money for its shareholders although a lot of corporate executives also use them as money making playgrounds as well. Nonetheless, one way or the other, corporate profits, i.e., making money, is the sole purpose. If “buddying up” to you in the short term will help them accomplish that purpose in the long run, then that tactic will be used as well.
You will know that things have gone awry when there is a change in your Claims Representative, which is why you need to beware the claims representative. This is a sure sign of storm clouds on the horizon. You will now meet the hatchet man who will forget all the “we will take care of you” promises made by your former buddy who is now off being some other unsuspecting soul’s buddy. In the meantime, you are being informed out of the blue with no warning whatsoever that benefits have being terminated, sometimes with just a cold, impersonal phone call or voice mail from a new Claims Representative you have never heard of before. This call will sometimes come even soon after your buddy had called and told you everything is set- set for what, he did not tell you. The amazing thing is they will often have the audacity to suggest you can handle the all-important appeal of the benefit denial on your own without the assistance of an attorney.
Now, this is not to say you should not be polite to the insurance company’s representatives. Just please beware the claims representative and of any intimation on the part of your Claims Representative. They will use this tactic specifically to obtain information concerning your financial circumstances and other specifics regarding your living situation. This will ultimately be used against you if your claim ever gets to the point of a lawsuit, at which time the insurance will try to “starve you out” to get you to settle for less. It is a sad commentary but true. While I push to move every case along as best I can, the number of clients I have to refer to a bankruptcy attorney is a sad testament to this truth.
It is my purposes that you treat your claim as the serious business it really is. It involves a business transaction relating a very important income stream necessary for you to support yourself and your family.
Please keep in mind that the foregoing is not intended as legal advice applicable to any individual person’s unique legal situation. Its sole purpose is to give a general idea of the existing status of the law as it applies to the point of law addressed above. You cannot rely on the foregoing as legal advice. You cannot make legal decisions based on its contents. If you have questions arising out of this point of law, you should contact an attorney who routinely handles claims involving policies of disability insurance. The law offices of Herbert M. Hill, P.A. handles such cases and would welcome the opportunity to discuss your case with you, at no charge. You can contact me at 407-839-0005 or at hmh@herbertmhill.com.
If you would like, after discussing your case, we can set a conference. That conference would be free of charge and you would be under no obligation to hire me nor would you feel any pressure from me to do so.
Herbert M. Hill, P.A. is a law firm located in Orlando, Florida with a practice extending throughout the state of Florida and the southeastern part of the United States. Areas of practice include disability and employee benefit claims of all sorts. The firm handles any claims arising under the Employee Retirement Income Security Act (known and referred to as “ERISA”) for disability benefits, medical benefits, retirement benefits of any sort, including pension, 401k, termination agreements or the like as well as claims arising under private disability policies.
