The purpose of this post is to see if the manner in which my insurer has communicated with my doctor is improper. (In particular, my LTD contract states that the insurer “will in no way disturb the Physician/patient relationship.”)
I recently had my doctor fill out the annual Physician’s Form and I returned it to my insurer. A few weeks after returning the Physician’s Form I found out that upon receipt of the form the insurer had contacted my doctor for more information.
However Instead of asking for my medical file, the insurer had started to engage my doctor in medical a conversation. In particular, the insurer had started to discuss, (by commenting in writing), the contents of the Physician’s Form as filled by my doctor, writing to him how particular sections of the filled form were not supporting the limitations that my doctor had listed, and communicating to how the form was not sufficient to establish disability.
While writing to my doctor the insurer also provided him, (in writing), a wrong definition of disability, stating that according to what my doctor had written in the form, I do not have a total functionality loss to support an inability to return to work. (This is an incorrect definition of disability because I only have to be unable to perform and maintain in an occupation similar to my previous one, and consistent with my training, skills, work experience.)
Then, instead of asking for my medical file the insurer started to ask for “specific clinical exams and diagnostic findings” to support disability! They did not stop at asking once, but keep at asking it a couple more times. Finally, after the third such request, my doctor, frustrated by these repeated requests, wrote to my insurer that he has referred me to a specialist. (I actually do not mind this, however, I feel that the insurer should not influence my doctor’s choices, since once this occurs, what stops the insurer from doing it again in the future!?)
I should note that In the process of making all of these requests, the insurer had failed to provide any written disclosure authorization, despite that i had signed one and gave it to my insurer.
Is any of this behavior amounting to breach of contract? My contract states that insurer "will in no way disturb the Physician/patient relationship. " Are there any actions I should take?
(Note: I have tried to make this post as anonymous as possible, however, I am not too concerned about the insurer reading this, since I already protested in regard to these actions.)