Follow up calls

My new case manager informed that he would followed up with me every 5 weeks. Is this normal? I am on LTD not STD.

There is no “normal”.
They can call as often as they like.
If they call with an unreasonable frequency, you might need to sue.
I would talk to them if the frequency bothers you.
If you’re at the start of your claim and depending on your medical condition, the insurance company may call more often.
The frequency may decrease with time.

2 Likes

Thanks for your insight. I am not new but rather a few years on LTD. Frequently of follow ups were 3 to 4 months apart so I found it strange that it moved to every 5 weeks. I am hoping it will decrease just because I need time to heal and don’t want the additional stress that can intensify my illness.

Request your claim file from them, it may say why the frequency has increased.

Can you request your claim file from the LTD company? What rights do you have under Privacy and access to Freedom of information?

Can I request a copy of their cost vs benefit analysis? Is that for the first 2yrs of LTD?

1 Like

I was in exactly the same situation. A new case manager took over my case and decided to call every 4 weeks after I have been on LTD for many years. I think your claim is now moved to very active management or it’s just a very young individual started his new career trying to perform. I did talk with my psychiatrist, who always suggested mail and email communications, but the insurance company never listened. I refused the monthly call and I am asked for IMEs. I requested my claim file but files are missing, claim management form of 70+ pages with only my name on few pages, I requested again and was told all other 70+ pages are empty so they didn’t copy to me. It’s hard to believe but I cannot do anything about it since they haven’t cut my claim yet.

1 Like

Yes.
I wouldn’t do it unless you’re being cut off though.
If you’re being sent to an IME you can get their report from them (you have to pay for copying).
I would talk to a lawyer:

Probably not.
It is proprietary to them.

Hi, why not ask for claim file unless the one is being cut off? I think when one’s claim is moved to active managements, ie various of requests of frequent reviews, phone calls, rehabs, IMEs, it’s the time for asking for the file to get some idea of what’s really going on.

I guess.
I never needed to get my report and I wonder if a non-lawyer or insurance person would understand it.
I guess there could be something obvious to a layperson.

1 Like

Oh yeah, it’s your file with all medical records from your visits, and the conservation records you had with them. It’s great way to understand what’s really going on, how they reviewed your claims, how surveillance was done etc. it’s also a great opportunity to correct for any errors they have in your file.

I am a little suspicious of their motives as they offered an intervention after a year! I can file a freedom of information act according to my knowledge and request and see how they have collected and shared my personal info. I have a feeling they have been co ordinating with my employer behind my back!!

What’s an intervention?

They just moved your file to active management. Did you give them a reason? There may be something your doctor wrote in her report.

My case was in passive management for 2-3 years. They didn’t call me for one year at all. Then I told my doctor that I wanted to try volunteering as an exposure to help me in treatment of my anxiety. She actually wrote that in her report to the insurer. After that my insurer moved my case into active management. And has been calling me almost every two weeks ever since saying that my condition has improved and demanding that I go back to work. My therapist told me it’s like Catch-22. You tell them that you want to do something that will help you to improve and in return they just use it against you. And now it scared me from doing anything to improve at all. So my therapist decided that it will be better for me if I do different exposures like volunteering without telling my insurer.

1 Like

@Elaine did you end up settling with your insurance company? Or do you still receive monthly benefits?

My case manager sent a letter to my therapist stating that their doctor recommended that I do 8-week behavioral activation program and go back to work after. My therapist replied that I am not ready for that kind of program as I still have symptoms of my conditions. So this is how they used my initiative to try volunteering against me. I don’t know what their response will be. They may just cut off my benefits as their doctor thinks I am ready to go back to work. In case if they just leave my benefits and let me stay on LTD there will be no more initiatives from me any more.

You really need to be careful what you tell your case manager as they can twist everything to benefit them. And of course, if you tell your doctor how much progress you are making she will surely put it down in her report to them as doctors cannot really withhold any information. Basically you shouldn’t tell too much positive information about your health or take too much initiative as it will be used against you. You have to be to some degree miserable because they don’t want to see you flourish and collect benefits.

2 Likes

I don’t speak on the telephone to anyone from my insurer for that reason.
“claimant says she is ready to return to work” but in reality my go to phrase was constantly, “I would love to go back to work when my treating medical doctor approves my return to work.”

I have already been warned in writing that according to the plan volunteering is considered “work” as the expectations would be the same (dress accordingly, show up on time, stay for a set time period, interact, mental process etc)

That being said, there was a male coworker on benefits for the same diagnosis as mine, who not only volunteered doing his actual job, he was publicly commended for his volunteer work. Go figure.

2 Likes

My case manager does the same thing :slightly_smiling_face: If she doesn’t cut me off I am considering not talking to her on the phone again. How can I tell her that I won’t be able to talk on the phone?

Probably it is the same in my policy. I should’ve checked before proposing volunteering. My mistake.

Did he go back to work after volunteering?

1 Like

He went back to work for a few months before losing the re-election for his position (that’s how his employment worked, whereas I was a permanent employee)

I just stopped taking their calls after they terminated me the first time. I consulted a law firm by telephone and email the same day. On their advice I sent an email “Upon legal advice, going forward I am only able to communicate with insurer via email or regular post mail.”
There is no policy in my plan saying I need to talk to them on the phone.

I log in to their secure server, save and print any letters/emails and keep a file.

1 Like

Then I should come up with some excuse to stop phone conversations with them. Something like “I am afraid that exposure to radiation from cell phones can be harmful to my health”. Will that do? They will think I am losing my mind :joy:

1 Like

Haha
I was very forward. Communicating by telephone was stressful to my health and it was supported in further letters from my treating doctor and by their own therapist.

1 Like