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Life Health > Health Insurance > Life Insurance Strategies

Claims Specialist Calls For Informal Solutions

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Bonita Springs, Fla.

Insurers, producers and regulators should find ways to streamline the disability insurance claims process without creating more red tape, according to a veteran claims consultant.

Gerald Katz of Disability Income Concepts Inc., Weston, Fla., spent years working in the disability insurance industry as a distributor and product designer with a predecessor company of what is now Unum, Chattanooga, Tenn., and he is a past president of the Disability Insurance Training Council.

For more than a decade, Katz has been operating on his own as a disability insurance expert witness and disability insurance claims consultant.

Over the past five years, since the disability claim controversy crested, scrutiny of the claim process “has probably lightened up the aggressiveness of claims investigators,” Katz said here in an interview at the disability insurance conference organized by JHA, Portland, Maine. “But they’re still very thorough.”

In part because insurers have concerns about consumers who might filing weak or false claims, insurers often ask claimants for more information without giving many, if any, clues about why, Katz said.

“The majority of legitimate claims are certainly paid,” but claimants may experience delays, and what seem to be unnecessarily extensive requests for documentation before getting any benefits, Katz said.

Katz sees disability insurance producers as a key part of the solution to the problems with the claims process.

“Most insurance agents don’t understand the claims process,” Katz said.

Good places for producers to learn the ins and outs of the claims process include the disability claims litigation seminar organized each year by the American Conference Institute, New York, and the annual conference of the International DI Society, Seal Beach, Calif., Katz said.

Katz and W. Harold Petersen, another disability insurance veteran, were attending the JHA conference in part to promote the next IDIS annual conference, scheduled to start Oct. 27 in Las Vegas.

Insurers also could help, by giving claimants more advice about the claims process, Katz said.

State insurance regulators could play a role, but, ideally, by holding informal conversations with insurers and enforcing existing laws and regulations, not by pushing for new laws and adopting new regulations, Katz said.

Creating new laws and regulations could chase insurers away from the market, which is only now starting to recover from the doldrums of the 1990s, without doing much to help consumers, Katz said.


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