Stressful LTD telephone interrogations


#1

From the very start of my sick benefits claim (STD) and now LTD case manager calls me monthly, sometimes more often with repeated questions about my activity levels and types, my diagnosis, prognosis, therapies, drugs, etc. The same questions are repeated over and over again during the same call using different terms as if she is trying to see if I will contradict myself. The case manager’s tone is aggressive, she becomes frustrated by my answers and has tried to manipulate my words during every phone call. I have been lied to on numerous occasions during these phone calls right from the start of the claim. In the latest call I was told that they had spoken to my therapist on the phone and needed to get additional information that they had forgotten to ask her about the duration of therapy. When I told the therapist about the call she was shocked, the insurance company had never spoken with her on the phone. She had responded to their voice mail with her email address ( which they already had) and asked them to send her any questions via email along with any forms they might need filled out. She has not received any response. These phone calls are so stressful, that I am reduced to tears, and it is not helping my recovery. Both my therapist and Doctor have suggested that I restrict communication to email format. Can I request that these questions be sent to me via email or will they say I’m not cooperating and end my claim?


#2

You could request a copy of your claim file for your records. Just a simple written request asking for a full and complete copy.

That way you can see what is being documented. It will either ease your mind or it will show you if conversations are being documented with a bias or incorrectly.

If you go the route of asking for email documentation only, which is your right, your Insurer will comply. Your Insurer will not like it though.

For my spouse because he found the calls too much he signed a form allowing me to speak on his behalf–which I have only done by email. Perhaps you have someone who could assist you that way. I would send medical updates, list of medications and every date he saw a treatment provider and Doctor.

Comprehensive, factual and to the point reports. My only caution is to not speak in absolutes unless it is 100% true. Do not say you can not walk more than a block–if there are times when you have to walk longer. If you can only walk a block and then the pain really starts to flare–that is the way to record your symptoms,

Insurers always try to get you to say you can not do something and then catch you that one time doing what you said you could not do. So always speak about your struggles, it is difficult, I could do it but I will suffer for it…

Good luck and don’t over stress. Case managers are just people-some are really good and fair and others are just trying to move up the ladder --and a case manager is rated on closed claims! They are often also rated on amount of correspondence–so the email route may reduce their contact.


#3

I would do this after every phone call. :slight_smile:
Is there any legality about how often they have to provide the file?


#4

I would not do it after every call as that might be excessive. You can always send a letter/email documenting the call in your own words. I would just ask for the claim file and go from there.


#5

They are usually quite annoying at the beginning of the claim. After a year or so on LTD they rarely call. My insurer used to call me every 2 weeks and ask same questions over and over and now they just talk with my doctor directly and call me once in 6 month or so.


#6

It has been over one year, and I cannot handle these calls anymore. I find being lied to and being interrogated over and over again extremely upsetting. The case manager reacts with incredulous disbelief to the terrible symptoms of my illness and it is humiliating. It has worn me down to the point of despair, so I won’t be calling them for any reason, my contact will be via email.


#7

Oh boy! hang in there… I would hope that your doctor should ask for any correspondence to be in writing and that you get to see the questions ask and answer them WITH your doctor. Do not give any additional explanation, just answer the questions asked in the letter. Send them a letter or email now asking that going forward you and/or the doctor wants questions asked in letter format and will be answered in that manner in order to control the obvious repetitiveness. The point is that it seems that your doctor is supporting you, and that is the best thing! Good luck!