I’m under LTD own occupation and approaching COD. I may retain counsel because despite minoring in law, I’m just tired of the mental demands of watching what I speak and write. I’m not worried about the cost of counsel but what I am worried about is what LLMs are telling me (e.g. ChatGPT) because what they’re saying would be…seriously questionable if this went to litigation.
For those that retained counsel:
Did your case manager immediately stop talking to you? E.g. file handed off to the legal team?
Was there a payment freeze as the insurer transfers the case to legal?
#2 is precisely what had me going…wtf. They can’t just stop paying a LTD claim due to a transfer of a file as eligibility is based on functional limitations, inability to do own occupation, etc etc. LLMs were fairly confident that this would happen in real life which has me scratching my head.
If they do cut off my payments immediately, I’d be fine financially, but I’d rather be prepared for it if I retain counsel so they can speak for me.
Instead of communicating with the LTD insurer for your ongoing LTD claim, you want a lawyer to do it for you? Am understanding your plan properly?
If you are not currently in litigation against the insurer the claims manager might only continue to try contact you and possibly ignore any request to talk to your lawyer instead. The moment you make yourself directly unavailable to the insurer for information gathering you have likely breached your LTD contract, and the insurer would be within their rights to terminate your LTD payments.
Edit: changed my response. I’ve now talked to two people who said their lawyer is their contact person with their insurance company, but at least once a year the insurer the makes sure they talk directly to the claimant.
Things only go to litigation if the insurance company thinks it’s got a reason to stop paying. Otherwise they just keep paying you and there is nothing to litigate.
LLMs are a terrible resource for legal advice; they are just a probability-based guesstimate of what word is most likely to be used next.
I can speak directly to this. I am a lawyer and have worked on behalf of clients who are on approved LTD claims. We work directly with the insurance company and there are no issues. We make it clear that they can still contact the client but that we are involve as our client’s claim manager. I agree with Caro that the AI is way off base on this one. No insurer would immediately freeze payments just because you hired a lawyer on an approved claim. I think the AI is conflating there situation where your claim is already denied and you are going to litigation – during which the insurer would only deal with your lawyer.
David Brannen
Disability Lawyer with Resolute Legal
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