What Can My Insurance Company Do When it is Investigating My Claim?

What the Disability Insurance Company Can Do

Generally speaking, here are a few things that courts will typically allow insurance companies to do when they are investigating your claim:

  1.  Audit your tax returns and billing records;
  2.  Review your medical files;
  3.  Use a private investigator to conduct video and photograph surveillance;
  4.  Look at your public Facebook profile and pictures;
  5.  Follow you on Twitter;
  6.  Order an Independent Medical Exam;
  7.  Have an insurance company doctor opine about your disability;
  8.  Ask for a Functional Capacity Evaluation;
  9.  Contact your treating physician;
  10.  Schedule face-to-face interviews with you;
  11.  Interview your family, friends, co-workers and employees;
  12.  Demand precise quantifications of your time spent in every professional activity pre- and post-disability; and
  13.  Pay your claim under a reservation of rights.

What the Disability Insurance Company Cannot Do

Generally speaking, here are a few things that courts typically will not allow insurance companies to do when they are investigating your claim:

  1.  Impose requirements on you that are not in your policy;
  2.  Attempt to influence the opinions of independent medical examiners;
  3.  Misrepresent policy provisions;
  4.  Conduct abusive interviews;
  5.  Unfairly delay a decision on your claim;
  6.  Fail to conduct a timely, adequate investigation of your disability claim;
  7.  Destroy key documents;
  8.  Lie about actions taken on a claim;
  9.  Place their financial interests ahead of your contractual rights; and
  10. Force you to litigate by offering an unreasonably low lump-sum buyout.

When it comes to claims investigation, disability insurance companies often skirt the limits of what they can legally do.  If you think your insurer might be acting in bad faith, contact an attorney to protect your disability benefits.

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