Give a Little TLC

In our work, we read a lot of case reports, articles, blogs and treatises on insurance. Most concern the latest legal decisions and what they mean to insurance litigation; many concern settlement procedures, buyouts and other practical aspects of pursuing claims against insurance companies.

But, very few, if any, are written from the point of view of the plight of the actual policyholder – the person whose righteous claim has been denied. What goes on in the mind of the person who truly believes he or she has met the requirements to obtain benefits, but is blindsided when the insurer turns down the claim?

And, when we say “met the requirements”, it means that some kind of personal disaster has befallen the policyholders, usually affecting the very basic elements of their lives. After all, people usually don’t buy personal insurance except for life, health, disability income and similar life-altering happenings.

How do these people cope?

First and foremost, if they have a disability which prevents them from working and bringing home a paycheck, they need financial support for food, medication, ordinary living expenses for their families. This should be understood by everybody. All of an insured’s time and energy go into keeping body and soul together for the family.

The stress created by such a situation can be overwhelming even for a healthy person. For people suffering from a physical or mental disability severe enough to prevent them from earning a living, the stress is devastating. Pile a questionable insurance company claim denial on top of this package of woes and the outlook is even grimmer for the claimant.

The point we are driving at is that everyone involved on the claimant’s behalf must be very aware that the claimant needs some TLC from the people in their corner, even if those people are not in the habit of offering TLC.

Doctors and lawyers are accustomed to being deferred to in their everyday practices and are, maybe, due some acknowledgement for their importance in many people’s lives. But, when it comes to denied insureds whose very financial future and wellbeing are threatened, they must find some extra TLC to help carry the people they serve through the crisis.

As busy as professionals are, we have to find that little extra bit of time to take a call personally and talk to a client or patient when the world seems at an end to them. Such a sign of their doctor’s or lawyer’s particular interest in their case may do much to help give them the strength to go on.

From the denied claimant’s point of view, the situation is extreme. No job, no money and only one hope – that the lawyer and the doctor will be able to get the insurance company denial turned around. This is a large responsibility calling for skill on the part of the professionals to get the job done.

The extra effort we are calling for here is not in a professional sense. Doctors and lawyers, as a class, go all out professionally for their clients and patients in all matters. The extra effort required for denied insurance claimants is for the professional to be understanding and supportive through the claimant’s tough time. Find the time and energy to give a little TLC.

Being aware of the stress your client or patient is suffering is half the battle. Doing what you can to alleviate the stress is the other half.


The Phone Is A Client's Lifeline

The practice of law involves many things – knowledge of the law, writing ability, speaking ability, ability to present a logical argument in an interesting way, but, most of all, compassionate understanding of the “human condition” of clients.

It has always amazed us to hear from clients that the “human condition” aspect of practicing law can be so low on the totem pole of legal services to some practitioners. Helping a client through tough times should be priority Number One for all lawyers.

This is especially true of those pursuing disability income (ERISA and private) claims against insurance carriers who reflexively don’t pay. Claimants in these types of claims usually are laid low, both physically and mentally, by a devastating illness or injury which prevents them from performing their daily occupation, thereby cutting off income to themselves and their families.

Add to this condition, that in most cases the “nest egg” claimants may have set aside to try to secure their future, is eaten up quickly with ordinary housing and food costs which they need to keep themselves and the family going through the “no-pay” period. What a “human condition”:  Being seriously incapacitated and having no income!

It’s at that low point in their lives that disability income claimants comes to lawyers for help. They recognize that they stand very little chance of getting disability income payments from insurance companies unless they have knowledgeable legal representation to stand up to the well-staffed, specialized attorney corps insurers use to try to duck policy obligations.

It’s at that low point in their lives that most attorneys practicing disability income law recognize that their clients need more than just good “lawyering”. They also need good “peopling”. They need to project to the client that the client’s case is important to the lawyer and is getting the attention it needs to give it the best chance of resolution in the claimant’s favor. The most important thing, while a disability claim is pending, is for the client to really feel the lawyer understands the client’s economic situation and is doing everything in the lawyers’ power to get the job done quickly and correctly.

One of the smaller, but most important aspects of this caring lawyer-client attitude is one that some lawyers seem to ignore – returning phone calls promptly. If you are a client, what could give you a better feeling about how your case is being handled than to have your lawyer respond reasonably promptly to a phone call from you? It demonstrates that you are important enough to have your attorney take time out of a busy schedule to talk with you.

On the other hand, what could give a client a worse feeling than having the lawyer fail to return n calls for several days after they are made, or even fail to return them at all? Imagine what this phone call “non-etiquette” does to the psyche of a client who had already been laid low physically, mentally and financially. It is an inexcusable way to treat any client, let alone one who is incapacitated and pressing a disability income claim against an insurance company.

These types of client generally need liberal doses of TLC. They need encouragement and assurance that everything is being done to get their lives back on track. What they don’t need, most of all, is short shrift or even silence from the attorney they are banking on to help them.

Our law firm was started by a lawyer who was licensed in New Jersey in 1958 and 52 years later is still practicing law every day. One thing he insisted on when I joined the firm was that I and everyone else return client phone calls as soon as possible. Clients don’t hire you for your good looks, he said, they hire you to look after their interests. The best way to do that is to respond to them in a timely, efficient way. The best way to do that is to talk to them promptly when they let you know they want to talk.

By following this advice through the years, we have found that sometimes these older geezers know what they are talking about.