Do LTD insurers use physicians to do their dirty work?

When you bought your long-term disability (LTD) policy, you saw it as an investment for the future. After all, you have a one-in-four statistical possibility of becoming disabled before you retire.

Unfortunately, long-term disability insurers don’t always live up to their promises. Many of them go well out of their way to deny valid claims, and they use all different kinds of tactics. That can include using medical professionals in purposeful ways to minimize their financial obligations.

How do they manipulate medical providers to get what they want?

Insurance companies can subtly or overtly influence what doctors say in their reports through a variety of means:

• Selective information sharing: Insurance companies may only provide limited or selectively chosen medical records and information to a reviewing physician. By withholding certain details about the claimant’s condition or medical history, they can shape the physician’s perceptions.
• Biased physician selection: Some insurance companies may have a panel of preferred physicians or medical consultants who regularly review claims. These physicians may be selectively chosen because they are more conservative in their assessments, which can result in a higher likelihood of denied claims.
• Pressure to reach certain conclusions: Financial incentives or implied threats to the physician’s future employment can be very effective in securing results that favor the insurance company’s goals.
• Cherry-picking the information they provide: Disability insurance policies often contain complex and vague language, making it difficult for medical providers to understand the eligibility criteria a patient needs to meet. This complexity can be exploited by insurance companies to their advantage.

Long-term disability policies are important safety nets for people who suddenly develop disabilities in the prime of their working years, but it may take legal assistance to make an insurance company pay up.