Insurance Company’s Dirty Little Secret

Posted on February 4, 2009 by cjblog

Do you want to know a secret? Every day, millions of people pay good money for a disability policy that limits or terminates benefits for disability caused by pain, fatigue, or fibromyalgia. What is even more amazing is that the law allows it. This is OUTRAGEOUS!

The insurance company will whine that there is no objective evidence that you are in pain, or that you are tired and fatigued. When you send them your medical records with these symptoms - which your doctor used to treat your condition- they say it’s based on your own reports of pain or fatigue. As a result, they will either not pay benefits, or will severely limit your benefits.

You should know that there are many scientifically recognized and documented conditions related to pain and fatigue. The simple fact that there is not a standard test or lab study to make the diagnosis is no reason for the insurance company to limit, or eliminate, your benefits. Sometimes they will agree with the diagnosis, yet deny benefits, because the only evidence of disability comes from the patient’s complaint.

Until science catches up with the insurance company, you should do all you can to objectify your symptoms. Be descriptive of the nature, character, and location of your pain. If you experience increased heart rate or sweat profusely when experiencing pain, be sure to document it and relay this information to your physician. Take a videotape of you huffing and puffing after going up or down a flight of stairs, or whatever way you can objectify your illness, do it.

Ultimately, it is incumbent on you, the consumer, to know what you are buying. The insurance company won’t tell you this when they are selling you the policy. Get a copy of your disability policy now and see if it has limitations on benefits for any of these self- reported conditions. Talk to the person at work responsible for selecting the benefit plan. If the policy doesn’t offer you the benefits you will need, you should know you could buy your own individual coverage that offers you more protection.

This entry was posted in Benefits, Blog, Disability Claims, Tips by cjblog.