Insurance company communications are very important and it is important that all communications with representatives of the Insurance Company are handled in a very precise manner.
The first subject in Insurance Company Communications is written communications. I do not want to suggest the letters you send the insurance company to end up in the trash can but I have had numerous complaints from clients that the insurance company has denied receipt of documentation or correspondence which they have sent. All written communications should be sent in a way in which delivery can be verified. This can be by Certified Mail, Return Receipt Requested or by way of courier service. Ensure that you keep a copy of what was sent as well as the document which evidences delivery. Facsimile transmittal can be used as long as there is a cover sheet indicating the number of pages sent. When using facsimile also ensure you keep copy of the “transmission report” which every facsimile machine can generate. This will evidence the telephone number to which the document was sent, as well as the date and time. If your doctor or anyone else on your behalf sends documentation directly to the insurance company for communications, get a copy of what was sent and then send it again yourself.
Regarding written communications from the insurance company communications, please keep not only the letter or documents received but also keep the envelope and mark on the face of the envelope the date you received it. More often than not, the insurance company’s letters are not mailed on the date found on the face of the letter. The postmark on the envelope evidences the date of mailing. The reason it is important to know the date you received some letters is because some time frames commence from the date of receipt.
Keep a copy of all documents to and from the insurance company in a file in one place, in a chronological order.
The second subject is oral communications. These should be handled with your personal “case diary” before you. Note the date and time of the conversation. Before you engage in the substance of the conversation, ensure that you get the representative’s full name (”Bob” is not enough). If they will not give it, either get their employee number or refuse to talk to them. They know your full name. You must be able to get back in touch with them or at least be able to identify with whom you spoke.. Along these lines, get a return telephone number with a direct extension. Again, if they will not give this, refuse to talk to them, this is important with your insurance company communications. They know how to get in touch with you easily. You should not be forced to work your way through the impenetrable telephone maze which many insurance companies have in place. Only after you are on a level playing field should you talk with them. Again, these things should be done at the beginning of the conversation. During the conversation, keep notes on what was said, letting them know you are doing so. One good way to do this is to get them to repeat something they said “just so I make sure I understand.” Also, make sure your questions (the ones you have noted in your case diary) get answered.
Oral communications are problematic because, at the beginning of the claim, the claims representative will try to be your “buddy,” as if they are on your side. This is especially so when benefits have been approved. In fact, when a new claims representative later calls you, please ask why the change. What has probably happened is that an adverse decision has already been made and now you will deal with the “hatchet” man (or woman). They will not remember all the fair weather representations made by your “buddy.”
Take these insurance company communications seriously. Insurance companies are not really in the business of paying benefits. That costs them money. They are in the business of collecting premiums and keeping pay outs to a minimum, to the point of a lawsuit, if necessary. Indeed, insurance companies are as much in the litigation business as are attorneys. Their representatives are highly trained to this end, even the “buddies.” Remember that insurance companies already have attorneys on staff who direct the claims handling process. When your case becomes too expensive or looks like there may be a long pay out, efforts will be made by the insurance company to reduce its exposure. Yes, an insurance company is an “it” which has no care whatsoever for you, despite the friendly voice on the telephone line. An insurance company is a legal fiction which by its nature is heartless and soulless whose only reason for existence is to generate a profitable bottom line for its shareholders. If you want to read a chilling comment on the subject, I offer one from Abraham Lincoln from almost 150 years ago which I believe is coming to pass these days before our very eyes:
“I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. As a result of the war, corporations have been enthroned and an era of corruption in high places will follow, and the money-power of the country will endeavor to prolong its reign by working upon the prejudices of the people until all wealth is aggregated in a few hands and the Republic is destroyed. I feel at this moment more anxiety for the safety of my country than ever before, even in the midst of war. God grant that my suspicions may prove groundless.”
– U.S. President Abraham Lincoln, Nov. 21, 1864 (letter to Col. William F. Elkins)
When talking with a claims representative about your insurance company communications, always keep in mind with whom you are really dealing!
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.
ded 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.
