When someone gets arrested, the police are required by law to read them their Miranda Rights, one of which is “You have the right to remain silent. Anything you say can and will be used against you…”
In actuality, this is a good rule for anyone embroiled in any kind of legal action, including making a claim with your insurance company. It applies in a number of ways, from not Tweeting out pictures of yourself doing things you shouldn’t be doing with your disability to making sure that you have an experienced disability attorney handle all of your correspondence with your insurer.
The most obvious reason for following these rules is so you don’t say or do anything to actively hurt your claim, but there’s another one that only pops up from time to time: sometimes insurers misinterpret communication, such as in the case of a claimant who “appealed” without knowing it by sending their insurers a letter in frustration.
Does Intent Matter in Communication?
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In this particular case, a claimant had their claim denied and wrote a letter saying they were “dismayed” by the decision. The insurer decided that this constituted an appeal and filed it as such, going through the regular appeals process without ever dealing with the claimant until it was decided that their appeal was unwarranted.
As crazy as it sounds, this is completely legal for the insurer to do as long as the claimant doesn’t suffer any “prejudice” from the clerical error that was made, which is exactly what a court ruled. How does that make sense if the claimant wasn’t able to mount a proper appeal with new evidence and support? The answer is that it doesn’t matter because the court has final say.
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That’s why it’s so important to learn all you can about the ERISA claims process by reading our free eBook, as well as making sure that all of your communication goes through an experienced professional who knows how to handle these kinds of cases. Be sure to check our blogs weekly for new information on how you can win and maintain your Long Term Disability Benefits.
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