2020 was a year of adjustment for everyone, including long term disability insurance companies. Now that 2021 is here, with some light at the end of the COVID-19 tunnel, these disability companies are beginning to adjust to a new way of working. Below, read more about what the long term disability insurance attorneys at Dell & Schaefer have observed in 2020 and some of the main changes we expect to see in 2021.
We expect that there will be an increased number of disability benefit denials for a variety of reasons.
Although some insurance carriers extended claimants a bit of grace in 2020, especially with matters like telehealth vs. in-person medical visits, 2021 is likely to bring an increase in claim denial rates. Not only are many insurance carriers merging, putting a fresh set of eyes on pending claims, but many long term disability claims adjusters seem to be subject to more oversight than they were in 2020.
A lot more compulsory medical exams are being requested because claimants are seeing their doctors less. These exams are supposed to be independent, but often they are not.
When a disability insurance carrier isn’t satisfied that the claimant’s medical records support their disability claim, they may order an independent medical examination (IME). Though these exams have “independent” in the name, the physician who performs them usually has a vested interest in denying the claim – after all, they’re being hired (and paid) by the insurance carrier. In addition, these exams are compulsory, and a claimant who refuses to go through with the IME may have their claim denied automatically.
Can telehealth doctor visits be accepted over physical exams by your doctor? We think you should continue to be physically examined as much as possible while being safe.
If you’ve already been on claim for a while, you may not have much to worry about when it comes to seeking telehealth instead of in-person doctor visits. But for new long term disability claimants, it’s a good idea to opt for physical exams over telehealth exams whenever possible (though only to the extent that it’s safe to do so). Insurance carriers just aren’t likely to take telehealth diagnoses and observations as seriously as they take in-person exam notes, and at the beginning stages of the claim process, it’s even more important for your medical records to be as thorough and complete as possible.
We think video surveillance will be back and that claimants should assume they are being videotaped when outside of their homes.
It’s been a longstanding practice of many long term disability insurance carriers to engage in video surveillance of claimants to see if they can be “caught” doing any physical activity they claimed to be unable to do. In 2020, this practice dropped off a bit; many claimants simply weren’t leaving their homes very often, while some of the insurance employees who performed this surveillance also were subject to shelter-in-place orders.
But in 2021, with more people receiving the COVID vaccine and beginning to resume life as normal, this video surveillance is likely to return. Claimants should know that whenever they’re outside their home, their disability insurance carrier may be watching.
The mergers of many disability insurance companies will result in a full review of many long term disability benefit claims.
In 2020, some of the biggest names in long term disability insurance merged, including Cigna and New York Life. These mergers can result in increased scrutiny of claims as each insurance carrier begins to adjust to its new (and combined) processes. And with larger staffs at many of these newly-merged companies, claim adjusters will have more time to carefully pore over each claimant’s file.
Although the pandemic seems likely to continue into 2021, insurance carriers are starting to go back to business as usual – or at least business as usual in this new environment. With increased disability denial rates and a rise in video surveillance, claimants must do all they can to ensure their disability benefits continue. Regardless of whether you’re just starting the claim process or have been on claim for years, the disability insurance attorneys at Dell & Schaefer can help you protect your benefits and see that any gaps or omissions in your claim file are addressed. Visit our website to learn more about the services we offer or give us a call to schedule your FREE consultation.