Rules of Engagement
There are rules of engagement, in my opinion, which should be followed when dealing with insurance companies (IC). Unfortunately, by the time you find this website, the enemy already holds the high ground. Be prepared to fight to regain it.
First, demand every communication in writing. Face-to-face communication is difficult to document, as are telephone calls. Be particularly wary of “friendly contacts” from IC reps prior to any evaluations arranged by the insurance company. Your answers to their “genuine questions of concern” will later be compared to your responses elicited during their scheduled evaluation. They are looking for contradictions useable against you. Also, a common trick like prosecutors use is to overcharge the allegations leveled against you. Later, they will deal or drop a few of the allegations, making themselves look better, and you walk away feeling good that your lawyer done his job well. He has protected your rights. In addition, keep all your communications on about the Tenth Grade level. When the time comes, spring the trap—they won’t see it coming. Brief your Congressman, sending it registered mail.
Second, try to document (videotape) any medical evaluations scheduled for the insurance company. There will be objections, but be polite and respectful. That is your secret weapon—they won’t see it coming. Make a note of your attempt. Why is there no law requiring a mandatory videotaping. Why would anyone object if the evaluation were truly independent? Brief your Congressman; he can deny no knowledge.
Third, if the IC assigns you a case manager and that person accompanies you to your doctor appointments, restrict them to the waiting room. Also, request, in writing, your doctor not have any private consultations with your case manager. Both actions limit what the case manager reports back to the IC to the doctor’s actual notes. The former can be later compared to the latter. If the IC objects, have them explain why—in writing. If they refuse, make a note of it. Brief your Congressman.
Fourth, answer their questions truthfully, concisely, and succinctly. Do not offer more information than they ask for. Most people naturally feel the need to prove their case every time they open their mouth. One effective interrogation technique is to exaggerate an accusation against you. They are hoping to push you into a defensive mode where you will give them something to work with. The insurance company is not in the business to pay claims. Brief your Congressman.
Fifth, do not trust any administrative law judge (ALJ) to administer justice. They don’t seem to have a track record for holding the insurance companies accountable for their wrongful acts. For instance, my benefits were terminated for five months based on false information the IC and their law firm listed on federal forms LS-207 & 208. While the benefits have been recently reinstated, my family was put through five months of hell. My medical care was delayed for those months, which extended my misery. I am a firm believer in vengeance, punishment that is inflicted in return for a wrong. I have a hearing before an ALJ scheduled for October. I plan to present the presiding Judge with seven Orders to Show Cause for his signature. Once signed, the Orders will be served upon the Claims Adjuster, her supervisor and Galichon and Walker, two lawyers of a law firm responsible for terminating my benefits. Three orders will be served upon the President, Vice-President and Secretary of AIG. The Order will direct all served to appear before the Judge and show cause why they should not be charged with falsifying federal documents for monetary gain and the misrepresentation of facts to deny benefits under the Longshore Act. Unless the Judge reduces the charges to misdemeanors, all are felonies. Whatever happens “why” will be the next question asked about this “individual case.” If the ALJ refuses to comply, I will press him to explain. This creepy shit has gone on too long.
General Orders (memory hooks):
1. Approach this conflict as a war. The final battlefield is the court room.
2. Demand all communications in writing. Notify the opposing force with a registered letter, and remind them periodically with emails. Include this warning in emails they would not want to “accidentally lose.” Get a loose-leaf binder. Place all letters, emails, LS forms, etc. in this binder correlated by date. Memories fade and pain doesn’t help. And testimony means nothing without collaboration.
3. Demand all communications in writing! (It is that important). You cannot document home visits or phone calls. Eliminate these. You don’t want insurgents operating behind your lines! The Claims Adjuster and Claims Examiner will be friendly; coming off so genuinely concerned about your health and well being. This is fake. Their motive is This is the trigger for a booby trap laid for you later on. If the bad guys can say “I didn’t say that!” you’ve screwed the pooch.
4. Do not try to impress them. Everyone does it. It is an ego thing. You are not sending the message “I am smart. Don’t screw with me,” as you might believe. You are actually set yourself up for a fall. Rather, take the opposite approach. Base all your written communication on the 10th grade level. How would a high-school kid write it? The opposing force does not know your strength. If they feel they can buffalo you, they will commit themselves early– in writing. Spring the trap when it is necessary. They don’t see it coming and you hold the evidence.
5. Assume nothing; verify everything. Is the medical evaluator licensed to practice in your state? Can he write prescriptions? If no, why not? Is he qualified to render the opinions he renders? Is the doctor really qualified to spout psychology when all he’s ever written is children’s books? How do you check them out? Ask your doctor.
6. Guard your signature like you would your little sister amongst lawyers and politicians. Sign nothing. If the bad guys tell you by not signing you risk losing your benefits, sign it. Just include the threat in a notation next to your signature. You’ve just signed it “under duress.” Absolve no one of their accountability. If an evaluator is going to run his mouth, he is going to stand good for it. Sign nothing agreeing to hold him “harmless.”
7. Follow the money, i.e., who benefits? The war in Afghanistan started eight years ago. Why has it taken so long to exam this problem? Question: What are you afraid of? Why would you care? You get the idea. This can lead to hidden information; hints to the enemy’s battle plan. Information is a powerful weapon.
8. There is no Geneva Convention. Like North Korea, the Corporation would not recognize it anyway. You are not a person. You are a file number threatening their bottom line. Name, Rank and Serial Number only. Do not volunteer information! Answer your captor’s questions, but offer no more. Resist the urge to plead your case every time you interact with them. They will confront you with an inconsistent answer you made to an un-guarded question—no matter how innocent– weeks or months before to one elicited later in a friendly, “how have you been” contact, or not-so-friendly deposition. Whatever you say will be used against you… If you give them nothing, they amount to nothing.
9. Always be polite and respectful. They won’t see it coming. If they think you are a pushover, all the better for you. They will buy the bullets for their own execution. Think about it and you will remember it.
If you choose to follow these rules of engagement and encounter anything interesting, please tell me about it. I am putting up a website to investigate these insurance companies and the people who work with them—more fun than I deserve. The corrupt is learning to fear the internet. It is our mission to teach them.
T. Lee Marshall, “Streetgang”