Disability insurance is like having a life jacket after the Titanic sank. It helps but there is a lot more involved in survival. We hope you purchased a very good policy and the company that stands behind it is honorable and trustworthy. As we have stated, the disability company will follow your contract with them to the letter the law. They are not your friend, but they are a for profit corporation with financial expectations. Your honest and to the point answers to their questions and requests just strengthens your claim in the long run.
Even if you have a severe injury or illness and have filed a claim without an attorney, you still may encounter challenges along the way. They include the chance that your insurance company may attempt to buy you. In addition, they have the option of reclassifying your status as disabled and denying your eligibility at any time. By carefully following your insurance policy requirements exactly your problems should be minimal.
Be prepared for unannounced or short notice visits by insurance personnel “who just happen to be in the area”. These visits are not mandatory and are somewhat of a fishing expedition. The company wants to verify your status beyond the physician reports that you faithfully send them as required in your policy. Whether you agree to see them is up to you. Our experience has been that they are mostly benign, but that doesn’t mean they all are innocent.
You may be subject to secretive videotaping at anytime. Go ahead and let them spend the money on surveillance. Your claim is valid and you cannot practice. Be aware that they may use only seconds of a multi-hour taping episode to invalidate your claim. This is illegal and cherry-picking videotape with out of context scenes is inappropriate. They may still try this ploy, but the law is on your side. As we have previously noted, those dentists who have psychological illnesses or orthopedic injuries (back and neck) have the highest risk of having significant problems with the entire claims process. You will need to see your physicians for care very frequently (monthly) to keep up with treatment and keep your claim valid. Strongly consider use of an attorney from the start if you have a claim that involves those illnesses or injuries. Other dentists with cardiac,cancer,brain damage, and other serious problems will be less likely to initially need legal services.
You may be asked to submit to an independent medical exam (IME) as required in your policy. This can occur at anytime. You will be required to attend this exam as noted in the policy you signed. Strongly consider taking an attorney with you or a legal nurse (RN) to monitor the exam. A second person in the room is recommended. Strongly consider audio or videotaping the exam. Request the credentials of the examiner prior to the exam and ensure that they are a medical doctor (MD). You most likely do not need to submit to any exam by a neurophysiologist or psychologist. Talk with your attorney about this in detail.
Your insurance company may rely on objective diagnoses as a basis of approving your claim. Be aware that they may want to ignore your subjective complaints. They may say that no matter how bad it hurts or what you cannot do, that you are not disabled according to the strict interpretation of your policy.
There are documented cases of disability fraud and we are not out to bash the disability industry as a whole. There have been significant incidences of bad faith lawsuits in the past against some large insurance firms. Feel free to explore the history of these legal battles on the internet. Just be aware of the risks to all of us who are legitimately disabled and that knowledge is the power succeed.
By being proactive, honest, and prompt with your future interactions with your insurance carriers; you will sleep easier and be able to move on with your life/career. We will continue to highlight the challenges you may encounter and will always be ready to answer questions and provide support.
WE ARE DENTISTS HELPING DENTISTS, WE CARE.