Insurance Case Manager Requiring Medical Update after 2 months of Approval


#1

Hello David,
Thank you for all the valuable posts, you have provided so much information that I dont think any of us can thank you enough.

I have been approved on LTD just little shy of 2 months now. It is mental illness LTD. I have received a call today from the case manager really drilling me with bunch of questions that I have just recently answered to the rep that approved my case. Then he said he is going to send documents to my Family Dr. for an update. Is this normal for all this to happen this fast?

I appreciate your advise.
Thank you


#2

Try not to talk too much to your Insurer. Answer all questions when asked truthfully, but do not volunteer additional information about your life. . Defer all questions about restrictions and limitations to your physician and all questions about your occupation to your employer. Answer all questions asked truthfully, then be quiet when the Insurer calls.

With mental health claims your Insurer wants to see that you are visiting your Doctor regularly- every two weeks to a month. That is usually needed for medication adjustments and such.
They will also want to see if you are getting counselling or referred to a specialist.

Mental health claims are rising and a huge cost for Insurers-they are often aggressive early on such claims.


#3

After your doctor gets the forms sent back, you may want to request your claim file from the insurer.
Anytime the Insurer requests something from my husband we then request an updated copy of his file.

You often have to then ask for missing documents and may be suprised at how you are misquoted or blatant untruths


#4

Yes it is normal for them to want to get a lot of information from you early on in a claim. Be as cooperative as possible. If they are asking about daily activities always give ranges of your good and bad days.


#5

Thank you very much for the input.
Greatly appreciated!