How insurance companies investigate a disability claim

If you have long-term disability insurance, either privately or through your employer, in California, you expect to be able to use it if an accident occurs that puts you out of work. Unfortunately, it is in the insurance company's best interest to deny your claim and they oftentimes go to long lengths to "prove" your disability is not that bad. It may help to know how they investigate claims and what you can do to improve your chances of approval. 

According to the National MS Society, when you file a disability claim the burden of proof is on you, so it is important to take the right steps. Before even filing, start filling out a diary of your symptoms or restrictions on a daily basis. Separately, make a list of all the specific requirements you have at work and how your disability interferes with them. Make an appointment with your doctor and bring all that information with you so you can work together to strengthen your claim. 

The insurer may ask that you see a physician of its choosing, which is valid, but make sure you see your own doctor first and that he or she stays involved throughout the process. Make sure you read through any paperwork from the insurance company before you sign so you do not give permission for things such as releasing tax returns or driving records.

Physicians News Digest reports that the insurance company will use any means necessary to investigate your claim and try to prove what you say otherwise. Some common techniques include:

  • Talking to neighbors and co-workers
  • Taking surveillance videos of you at any given time
  • Pouring over your social media accounts

Understand that pretty much anything that they find on the internet is fair game and that it is almost impossible to get rid of anything from the past. Stay away from posting on social media as much as possible so they cannot use anything against your case.



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