Why You Should Never Call the Insurance Company Before Speaking With an ERISA Attorney

Many claimants believe the first step after receiving a denial letter or experiencing problems with their long-term disability claim is to call the insurance company for clarification. It feels natural to ask questions, provide updates, or explain misunderstandings directly. Unfortunately, this instinct often harms the claim more than it helps. Once you contact the insurer, every word you say becomes part of the record that the company will later rely on to justify its decision.

Under ERISA, the administrative record controls the entire appeal. This means that innocent mistakes made during a phone call can limit your chances of winning benefits, even when your medical case is strong. Understanding why these conversations are so dangerous can help you avoid missteps that insurers routinely use to deny claims.

Why Insurance Company Calls Are Risky for Claimants

When you speak with the insurance company, the representative is not acting as your adviser. Their role is to gather information that supports the insurer’s position. Calls are documented in internal notes. These notes serve as evidence that the insurer can cite later in a denial or in litigation. A single poorly phrased comment can overshadow years of medical records.

Insurers often treat claimant phone calls as opportunities to collect statements about daily activities, limitations, work history, or symptoms. Without knowing how these questions are interpreted under ERISA standards, claimants may unintentionally give the insurer ammunition to argue that they are less impaired than the medical evidence suggests.

The Most Common Statement Errors Claimants Make

Claimants often speak casually during calls, forgetting that the insurer is documenting every detail. A few examples illustrate how quickly a comment can be weaponized.

• Many claimants minimize their symptoms to appear strong or avoid sounding negative. If you say you are feeling a little better or trying to be more active, the insurer may interpret this as proof of increased work capacity.
• Some claimants try to explain good days and bad days, but insurers frequently note only the higher functioning statements. Without context, the record creates a misleading picture of stability or improvement.
• Insurers sometimes ask open-ended questions about daily activities, driving, household chores, or hobbies. Even brief participation in minor tasks may be documented as evidence that you can sustain full-time work. Without detailing pain levels, rest periods, or the consequences of activity, the insurer will assume your abilities are greater than they are.
• Claimants may also attempt to clarify inconsistencies in their medical records without understanding how these clarifications will be interpreted. Insurers may later use the statement to claim that symptoms were exaggerated or unrelated to work duties.

Simply trying to be polite or cooperative can backfire. Insurers often treat reassurance or optimism as evidence of functional capacity.

Why ERISA Makes These Calls Even More Dangerous

ERISA restricts what evidence can be introduced in court. Judges typically cannot consider information that is not already included in the claim file. This means that once a harmful statement is documented, there is often no way to correct or explain it later.

Insurers know this. Many of their questions are designed to produce statements they can rely on during the appeal or litigation process. The administrative record becomes the entire case, so protecting it from damaging entries is essential.

How Our Attorneys Prevent Mistakes That Jeopardize Your Claim

An ERISA attorney understands how insurers interpret statements and how these statements influence the administrative record. Before any communication with the insurer occurs, an attorney can help you determine whether the conversation is necessary and how to respond in a way that preserves your rights.

Our attorneys can manage all communication with the insurer, ensuring that nothing is said that can be misinterpreted or used against you. We can also identify when the insurer is overreaching or requesting information they are not entitled to receive. By protecting the administrative record from harmful statements, an attorney strengthens your position from the start of the appeal through any potential litigation.

Protect Your ERISA Claim Before You Speak with the Insurance Company

Calling the insurance company before speaking with an attorney can create problems that cannot be undone. If you are facing a denied claim, confusing paperwork, or an insurer that keeps requesting more information, legal guidance is essential.

Our attorneys at Disability Insurance Law Group help claimants nationwide navigate ERISA claims and avoid mistakes that insurers use to justify denials. Before you speak with the insurance company, reach out for guidance that protects your rights.

Call 954-989-9000 or contact us online to schedule a consultation. We can help preserve the integrity of your record and position your claim for success.