An Interview with Eric Sloane
Question:I have Environmental Illness. Why does my insurance company not
believe that I
Answer: There are many reasons why many insurance companies
are skeptical about
Secondly, the symptoms of Environmental Illness are largely self-reported.
So are other conditions, such as chronic pain, soft tissue injuries, chronic
fatigue and others. Patients with these conditions also experience
a certain amount of skepticism from insurers, who frequently take the position
that, since a condition is "merely subjective", and cannot be "objectively"
verified, that it
Thirdly, you may be experiencing a situation common to many disabled people - the insurance companies tend to interpret their own policy definitions of "total disability" so strictly that many very sick and disabled people are nevertheless considered fit for some work.
I take issue with the insurers on all counts. First of all, they
should read their own policies. There is nothing in any policy that
I have seen which requires a claimant to have a condition that has been
recognized by medical science for a long time; indeed, there is nothing
that says that a firm diagnosis must have been made. Most policies
require a claimant to be suffering from an illness
Even if Environmental Illness is later found to be something different from what doctors currently believe, that would not change the fact that people are really sick - with something!
Also, there is nothing in disability policies that requires the illness to be objectively verifiable. Since most insurance claims are decided by people in offices who rarely, if ever, get to see the actual sick person, it is understandable that they feel more justified in allowing claims where there is solid evidence of something wrong. But in cases where that evidence is simply unavailable, because of the nature of the condition, it is my view that they just have to go a little further and acquire evidence of a different character. If the medical reports are not sufficiently informative, they should have someone pay a visit to the claimant, and perhaps talk to friends or family members, who can often vouch for how disabling a condition is.
This raises a question about medical reports. Since insurers are so dependent upon a paper trail, it makes sense to supply them with the best paper possible.
Doctors should be encouraged to write more informative (and legible!) reports.
Often, that will be the difference between a successful claim and a denied one.
The fact is that many doctors are too busy to pay much attention to reports,
and some of them are simply not good at it. However, they must be
made to understand that a very important part of their function is to communicate
the patient's condition to the official world - insurers, government etc.
Lastly, insurance companies sometimes forget that they are in the business of selling security. People rely in good faith on the coverage that suddenly vanishes when it is most needed. They are met with allegations that their conditions are not serious enough to keep them from working; that (surely) they could do something! Often, claimants have their own efforts to get well thrown back in their faces: eg. "If you are well enough to take walks, exercise and look after yourself, you are well enough to work." This attitude forgets that the first priority should be to get better. Most Environmental Illness sufferers have a limited amount of energy, and if they are ever going to get better they need to put that energy into working for their own recovery. There is also the issue of avoidance of exposure, which many companies do not understand. Many of them believe that totally safe environments exist, or can be created without too much difficulty. Many of you know how elusive the "safe environment" really is.
I guess the bottom line is that insurance companies are in the business
of making money, and claims are very costly. Every claim that
is denied saves them a lot of money. I am speculating here, however
I suspect that they probably count on the fact that a certain proportion
of people whose claims are denied will not have the energy or resources
to fight back.