Who should I talk to if I think I have a problem?
Well, often a policy holder when he/she notices that things are changing and that he/she may have to make an insurance claim contacts the insurance agent that sold them the policy in the first place. While that can be good, it can also be bad for several reasons. Agents don’t always have the necessary knowledge or experience to answer questions about coverage issues.
The important questions have to do with whether the policy will cover the particular injury or disability and to what extent the policy will cover them. There will be questions about the nature of the disability itself, permanent or temporary, total or partial? What kind of disability is it? How much in benefits will the policy have to pay and for how long? How is the present value of the future policy benefits calculated? All those kinds of questions come up.
So the insurance agent is not necessarily the best person in all situations to answer those questions and even the most well-meaning insurance agent can make big mistakes. For example, one of the biggest problems is that insurance companies will sometimes pay someone partial disability benefits instead of total disability benefits and they’ll say “Well you’re still working. You’re not in a wheelchair. We will pay you partial disability benefits.”
A lot of people will just accept that reasoning without further analysis. Partial benefits may not be the best or only available option but the policyholder will not likely know that. That’s where a coverage expert comes in who is most likely not an agent who sells policies but a lawyer with specific practice experience the evaluation of such policies.