If you receive a call or letter from your insurance company requesting an interview, don’t panic. It doesn’t mean you are about to lose your benefits or that your claim is about to be denied. An interview with an insurance company representative is not uncommon; up to 50% of claimants will be interviewed. However, you can prepare for long-term disability interview questions so you feel more confident.
You may have the option of doing the interview in person or on the phone. If you agree to an in-person interview, the insurance company representative may want to come to your home for the interview. The representative will observe you to see if your behavior is consistent with the severity of the symptoms you claimed. For example, if your disability claim states you can’t sit for more than 15 minutes at a time, but you sit for 30 or 45 minutes, he or she will note the obvious inconsistency.
The length of your interview will vary depending on the kind of disability you have, the stage of your claim review, and how thorough the representative is. Interviews usually last from 20 to 45 minutes, but it could take an hour or more. The representatives questions are meant to give him or her a better understanding of your case.
The representative will ask and observe whether your condition has improved, remained the same, or worsened. If the representative believes your condition has improved since you filed your claim, your approval may be in jeopardy.
The purpose of this question is for the representative to get an idea of the way your disability impacts your everyday activities. In particular, he or she might ask about your ability to take care of personal needs, cook, clean, drive, or shop.
The representative may not be aware of all your symptoms or may not have your complete medical records. This is a good time to provide that information and answer any questions about the type, frequency, and severity of your symptoms.
It’s natural for the representative to want to know when your disability began and what caused your inability to work. He or she wants to know if there was a specific event or if your condition progressed over time and rendered you unable to work. They may be trying to determine if you had some other reason for leaving not related to your disability. An example of this would be wanting to retire or being in danger of losing your job.
There are numerous ways your hobbies or activities outside the home can demonstrate your claim may not be accurate. Do you play a sport? Do you have a hobby that requires special skills? Or do you spend a great deal of time out of the house? Any inconsistencies between your claim and your behavior could be a red flag to the insurance company.
The representative wants to know if you plan to return to work and gauge if you’re motivated to go back to work if your condition improves. If you haven’t thought about this question, it’s time to do so.
If you have traveled recently or plan to travel in the near future, the representative will wonder if travel plans are an indication that you’re able to do other things, such as work.
This questions may be difficult to answer if your symptoms fluctuate in severity or are only active periodically. The representative may ask about your ability to walk, stand, sit, etc. to ensure your activities are consistent with your doctor’s report or your statements.
The insurance company wants to know if you are complying with your physician’s treatment plan and if the treatment has resulted in any improvement in your condition. Keep in mind that the representative may not be aware of what treatment you’ve had and he or she may press you for more detailed information.
You may be asked about the medication(s) you are taking, if they have improved your condition, or if you experience any side effects. Once again, the representative wants to be sure you’re complying with your doctor’s recommendations.