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What happens when a long term disability insurance company requests to do a field interview regarding your claim?



In today’s issue we are going to discuss the process of what happens when a long term disability insurance company requests to do a field interview regarding your claim and they may just call it an interview or a meeting. But essentially what that means is that the long term disability insurance policy carrier calls you up and they say – we would like to come meet with you. Generally it’s at your home and we want to discuss your claim. What I want you to know is that, if they call you up and want to talk to you about your claim, it’s definitely not to check to see how you are doing and to try to make you feel better. Long term disability carriers are trained to all about to return to work. When they come to see you, they want to see what’s your condition now, to see if you are able to return to work. So, you have to be prepared to answer every single one of your questions that is consistent with the language in the policy. Because they are looking to see that you are going to give out answers that would allow you to basically get back to work or no longer meet the definition of disability.

In this session I want to talk to Steven and Caesar about their experiences with field interviews. I know, Steve, you had two today in our office. I know that both of you and myself fly all over the country attending these field interviews, we attend these field interviews on phone. Caesar you just got back from Alabama yesterday. For example today, Steven, you had this field interview, what was the atmosphere like with two different disability insurance companies in the field interview?

Well, they always seem to send more of the charismatic people to come try to do those interviews, make it seem more friendly, more open. But the tone is always there, you can always see what’s insides their minds a little bit and where they are going to go. You can always kind of have an idea on a claim, what the issues might be, what the insurance company may want to know more about and when they come they hone in and sometimes they’ll know things that you had no idea even existed. When they research, sometimes a client doesn’t tell you necessarily what is truthful and open. So they’ll start bringing up certain things looking basically, like you said, for a way to show you don’t meet their definition on a strict technicality maybe or that you’re able to go back to work or as to what his motives were. Did you have a secondary motive for wanting to file for your disability, which is one of the cases I had today.

I think that people need to realize that the individuals that are doing these field interviews are usually employed by the disability insurance company and they are specially trained to do nothing but these field interviews. So they come on a specific mission to obtain specific information. They generally generate a 6 to 12 page report as to what their finding are and they also have specific instructions as to whether it’s from the claim examiner who is handling the claim, a manager, a physician, a director or someone at the company to find out specific information.

There are 24 opinions so far. Add your comment now.

Diane:

Is it legal for these people that come in your home to question you and to take your picture?

Attorney Greg Dell:

Diane,

If you let them in your home and give them permission then it is legal. If you don’t give them permission in your home, then they can’t take your picture.

Please check out our video on Field Interviews by Disability Insurance Companies.

Candace:

Do you have to do a recorded field interview if it is requested?

Attorney Greg Dell:

Candace,

Good Question. It depends on what your policy says. I have had situations where I have told clients to not attend the field interview and then I will tell the carrier to send their questions in writing. Most policies do not require appearance at a field interview. You need to read your policy very carefully.

Mark:

I have a Berkshire Life policy before Guardian bought them out back in 2002, and I looked in my policy to see if there was a requirement for a field interview. To my shock, there was no such requirement that I had to meet with a field manager for an interview. Only that they could send me to a physician for a medical exam. So I take it that I have no contractual obligation to meet with them, and I should respectfully decline?? My advice would be for all claimants to review their contracts to see what is legally required of them by the insurance companies.

Attorney Stephen Jessup:

Mark,

You are correct that many policies do not explicitly state you must submit to a field interview. However, I would caution you in declining an interview, as the policy most likely contains language regarding the right to take steps necessary for the reasonable review of your claim. As we are do not represent you, we can unfortunately not advise you as to whether you should decline or agree to an interview.

Colt:

This is so scummy. Can I deny them and suggest meet at my doctor’s office? I DO NOT WANT THEM IN MY HOME.

Attorney Stephen Jessup:

Colt,

You do not have to allow any interviewer in your home and it is questionable under most policies whether they have the right to even require you to meet with them in person. You can even suggest that the interview be conducted over the phone. How long have you been on claim and who is your insurance carrier. If your policy is an employer provided policy and you are nearing the “own” to “any” occupation definition of disability there stands the very likely chance the company is looking for a way to terminate your benefit. Please feel free to contact our office to discuss your claim in greater detail.

Jax:

After ten years of being MetLife Longterm disability they are now sending out a field representative. She asked me meet me one on one. I was caught off guard . I don’t have the company policy . When I became sick my company told me they couldn’t accommodate my disability . I asked for a laptop to work from home they denied it. They called me on a Sunday to tell me not to return to work that they would allow me to go on long term disability . That was in 2006. My company was acquired by another company . I called the new company they also don’t have my policy. MetLife won’t provide me with a copy. They say they don’t provide that to a claimant. I am at a loss . I don’t know my rights under my policy , I don’t know the motive of this interview. I have been in and out of doctors legitimately for POTS syndrome, lymes disease, autoimmune disease of the inner ear, 3 traumatic Brain Juries and a my neurologist thinks I have been misdiagnosed and he believes I have MS, I could go on and on. All I know about my policy is that I am approved to the year 2043 as long as I remain disabled under the companies plan policy. Which I don’t know it. Except for the fact that it’s any gainful employment. My cardiologist listed me permanently disabled 6 years ago. Help ?! I am nervous what MetLife is looking for .

Attorney Stephen Jessup:

Jax,

Please feel free to contact our office to discuss your case in detail as there are quite a few working components leading up to the requested field interview.

Lauren B.:

What are some of the reasons the LT disability insurance company would ask to interview the agent who sold the policy to the insured? Is this cause for concern?

Attorney Stephen Jessup:

Lauren,

It could be a cause for concern. If there are questions as to the truthfulness of the answers submitted (financial, medical, work history, etc) it could potentially be the carrier looking to rescind the policy. I would suggest you speak to your agent.

Karen:

I have recently been awarded my claim that I have with Met Life. It was retro active from Aug 2011. I have been contacted by Met Life that a Field representative want to conduct an interview at my home which will last 2 hours. I cannot sit for 1/2 an hour never mind 2 hours. Is this something I have to do?

Attorney Stephen Jessup:

Karen,

I have not seen a policy that says you have to meet with a representative in person. You can certainly ask MetLife to show you where in your policy they have the right to require it (though I doubt they will find it). Please feel free to contact our office to discuss your claim- needless to say there is cause for concern whenever an insurance company is conducting an investigation of a claim.

Toni:

I’ve been on disability for chronic migraine headaches; lower back pain resulting in 2 major surgeries; a double mastectomy with reconstruction; of course breast cancer treatment. Now I’m addicted to narcotics and suffer from major depression. I was approved by the Hartford for my 5th year in January 2016 and have been on SSI for 4 years. All to say I received a call 2 weeks ago from a new Hartford case manager stating my old car manager is gone and this new one wants to come to my house and interview me. I didn’t see the harm so I said “ok”. Now I’m hearing all these horror stories. Can I resend my “ok” and tell her I want to meet elsewhere? Why all of a sudden are they reopening my case?

Attorney Stephen Jessup:

Toni, you can certainly request to have the meeting at a neutral location. In many cases Hartford requests these interviews in advance of a denial, but with your claims history that is not as likely as if you were transitioning into the “any occupation” period of disability. That being said, please feel free to contact our office to discuss your claim and how we may be able to assist you should there be problems.

Gerry:

I’m having a phone interview with disability agent to go over my claim form that I sent in. Is that normal?

Attorney Stephen Jessup:

Gerry, depending on the insurance carrier, yes. Some carriers (particularly MetLife and Unum) like to have phone interviews with insureds. Please feel free to contact our office in advance of same to discuss your claim in detail.

Bill:

Unum wants to send a field rep out to discus my medical condition, from what I have researched it’s really an investigator with hub. Could this mean a denial? Currently pending approval for long term disability. Or is this normal for all claims being processed?

Attorney Rachel Alters:

Bill, this is typical of Unum, but often times they are coming out to observe you to see what condition you are really in. Often they have followed you with surveillance prior to the field interview and try to catch you in a lie. Just be careful with what you tell them. If you need assistance with your Unum claim I would be happy to speak with you. Just call my office and ask for Rachel Alters, Esq.

Johanna:

I have a hub meeting with Unum on july 5th at 3:00. What should I expect?

Attorney Alex Palamara:

Johanna, most field interviews are designed to not only get questions answered regarding your medical issues, treatment, medications, activities of daily living, your normal day, etc., but insurance companies are also sending investigators/interviewers to observe you to see how you act. Whether you have the ability to sit for the course of the interview, whether you seem distressed, etc. Always keep in mind that they are taking note of what you say verbally and even your non-verbal actions. They will also look at your home (if the interview is being conducted at your home) to see if they notice any devices to assist you (railings, walkers, etc.) These interviews are designed to gather information. Most times, they are looking for information to see if there is any reason to deny your claim. Most interviews take anywhere from 45 minutes to 3 hours. If you have any issues with your Unum claim, please do not hesitate to contact us.

Sayeeda R.:

I have received a letter about a filled interview from UNUM. Can I deny it and ask them to send the questions in writing as I have physical difficulty talking for long period of time due to my shortness of breath and facial structure and neuralgia.

Attorney Cesar Gavidia:

Sayeeda, some disability policies require that you participate in a field interview as part of the proof of loss requirement. However, you do not have to have it conducted at your home and may hire an attorney to prepare you and represent you through the field interview. Please contact our office to discuss your options.

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