Insurance companies review your medical file when you make a claim. If your disabling symptoms are not listed in the file, it may seem like you are making them up.

It is easy to understand that someone who is paralyzed is truly disabled. Unfortunately, chronic conditions do not come with spots, so the effects of chronic diseases are not always obvious. When dealing with conditions that have symptoms that cannot be tested or measured, insurance companies may take a sceptical view of some claims. For instance, symptoms like stiffness, fatigue and depression are hard to confirm. Remember, insurance companies deal every day with people trying to claim a disability that they do not have. People who cheat make things more difficult for those who are actually disabled.

Sadly, some insurance companies may also deny claims in the hope that the claimant will give up. These actions can result in claims for ‘bad faith.’ Canadian courts have ruled against a number of insurance companies that have engaged in unfair practices.

Avoiding problems when making a claim

Assuming that your insurer is acting in good faith, as most of them are, a few issues can cause problems with your claim. Surprisingly, these problems often are caused by people and their doctors.

Two common mistakes cause problems with claims. First, we tend to minimize our symptoms. No one should exaggerate symptoms, but at the same time, they should not be hidden from a doctor. If you are chronically ill, you may feel that you are whining if you list all of your problems. However, chronic illness brings with it a whole shopping list of symptoms. If your doctor does not know about all of your symptoms, they will not be recorded in your medical file. Insurance companies review your medical file when you make a claim. If your disabling symptoms are not listed in the file, it may seem like you are making them up.

Secondly, we often forget to give our doctor all of the information they need. We go to an appointment meaning to mention three or four concerns. In dealing with the most important issue we forget the others, only to remember them as we drive out of the parking lot.

Another barrier to a pain-free claim can rest with doctors. On occasion not everything that you tell your doctor ends up recorded in your file. You may have mentioned fatigue to your doctor off and on over a year. It fatigue is not recorded in your file, it may seem to the insurance company that it is not a significant issue. Imagine what your insurance adjuster might think if your claim is based on fatigue but your doctor has not recorded it as a problem.

One way to avoid both issues is to provide your doctor with information about your symptoms in writing. The Canadian Arthritis Society has produced an excellent resource called Making the Most of Your Visit to a Health Care Provider. This is available free from their website at www.arthritis.ca. Provide similar information about your diabetes in writing, and keep a copy for yourself. You will then be sure that your doctor knows about all of your symptoms, and that your file contains the necessary information.

Information gathering

You must continually educate yourself about your condition, its symptoms, and any new treatments that are available. Be sure that your information is coming from respected sources. Start with the national association for your condition, such as the Canadian Diabetes Association. They will provide links to credible resources. Follow them to learn about your condition.

Ongoing research changes the medical community’s understanding of many conditions. Specialists are realizing that symptoms they once thought unconnected are actually very real and common signs of a condition. While you do not want to bombard your doctor with everything you learn, it may help to occasionally bring in valid information relating to your diabetes.

Take the right steps

You can take steps to avoid problems with disability claims. Start by educating yourself, using credible, respected sources. Communicate with your health care provider clearly and efficiently. Do not exaggerate your symptoms, but do not minimize them either. Provide written lists of symptoms to be sure that the information makes it into your file. By playing an active role in your own health care, you can help knock down the barriers between you and your insurance company.