Long Term Disability In House Meeting x 3 ???

[Monkeybrains]

The insurance company wants to have a 3rd in house meeting with me this is what the policy says

"(Insurance Company) at its expense, will have the right and opportunity to have you examined by a physician, other health professional or vocational expert of our choice and/or interviewed by an authorized Company representative to determine the extent of any illness or injury for which you have made a claim ".

They had a in house meeting before the 2 year mark and a in house meeting with a Doctor after the 2 year mark just 3 weeks ago. Now they want to have another in house meeting with a person that works with people with chronic pain, What the #%@# is this ???. Can anyone give me some input on the wording of the policy and or any sugestions . Thanks

[benwire]

I'm from Canada but Just by the wording it looks like they can assess you with there choice of doctor or other health professional or vocational expert of our choice and/or interviewed by an authorized Company representative to determine the extent of any illness or injury for which you have made a claim ". Sounds to me like their dotting there i's and crosssing thier t's getting ready to cut you off. I would get legal advice if you can afford and make them have to listen to your doctors because their doctors are on their payroll and the decision will not be favorable to you. I have been fighting compo in Canada and this is a big game to them so you must learn how to play using thier own rules to protect yourself. The workers for comp will pull a lot of shit that is not lawful to get you off the payroll thats what they do look for anything.Good Luck

[skunk-mad]

it does sound like that they dont want to pay you but they cant find a reason not to if you know what i mean??...i think they are going to play on your chronic pain issue?..it sounds like they are going to try to get a specialist in "chronic pain" to say "your fine" when you are not..it would work in your favour if you ask your own dr to examine you? as well as there dr..then you have a back up opinion...best of luck sorting this out..

skunk-mad..

[gelu65]

You might want to go off your meds before you have a meeting with any one from the insurance company or pain clinics docs. That way they can evaluate you for your original problems while they are affecting you not when you are in a comfortable medicated condition. Jerry

[netbuddy]

You go to the racing track and put your money on a race and you take your chances. Same for an insurance company, they make a bet that your going to last the course and when you don't... they pay up or should do.

Like the previous posters in this thread... Get legal help, they're posturing for a sly wriggle out of paying up. Seen this before with claims on insurance policies and it makes little difference what insurance you are buying, home, health or life policies, they will find any way not to pay out.

Also note that they state that they can do things, well that is a two way thing and you could if your doctor has the time, attend this in-house meeting with you but on a practical side, it is likely you need a lawyer to ensure that you rights are not violated or that your being coerced or manoeuvred in to saying something that could be in interpreted or shown in a not so favourable light.

At the very least, you should record the in-house session for your protection and if the person coming to see you objects... I rest my case. If you do record the house call, your well within your rights, if you have a notice on your door that you have CCTV... Your covered because that person came in to your home knowing from the CCTV symbol that you have recording going on so you should not be bound by the regulations or laws on privacy. This could be as simple as you having your webcam plugged in to your PC or lappy.

See attached image I whipped up, resize it so its just legible and stick it to your door glass.

Good Luck.

[Monkeybrains]

Thanks Guys i got some more info today , They are sending a Therapist to my house to see if they can get more function out of me , maybe send me to rehab ?, Because i Cant do much and have Bad pain.

I asked them to send me in writing a copy of the policy and high light where it says i have to take part in this meeting because they had 2 meetings with me already. They said it is under one of the provisions in the policy. So lets see what they send me.

I Talked to a lawyer's office in January and they said that normaly there is always 2 in house meetings one before the 2 years and one after the 2 years and they told me that there's no use in gettting a lawyer untill they Cut Me Off , I have to follow what the policy says .

I'snt the whole idea of getting a lawyer is so you dont get Cut Off ??? lol

[Cannahope]

You'd think, but if the lawyer could make some money off of the situation they would, so you can probably be thankful the lawyer seems to have some ethics.

[clinton]

Take a video recorder to the examination. Video the whole thing. Start by giving introduction, date, time and event description. This way the doctor can not put words in your mouth by interpreting what you say to him. Some doctors will refuse to be recorded - stick by your guns. Tell insurance people that you plan to record everything.

Remember = the IME is NOT your friend. Be honest as if you lie even a little they can say you lie about the whole thing.

clinton