Just entering into 4th Qtr. profitability results Unum is denying large numbers of claims attempting to prepare for an economic recession in the spring.
As a result of Unum’s targeting of claims for profitability, I’m already aware of several claim denials without giving claimants/insureds adequate time to prepare their claims and submit proof of claim. Consistent with my prior posts, it appears Unum is jumping on “insufficient medical information” as cause to deny claims.
Instead of letting insureds know what is missing from the file, and giving adequate time to obtain it, Unum is denying claims without notice. One attorney commented that Unum is preparing for 4th Qtr. and the suspected oncoming recession. If Unum has already begun patterns of unfair denials then it’s certain other insurers will as well.
I hope my readers are taking me seriously when I post articles about incomplete and inadequate medical information. It is not enough in the claims process these days to just have your doctor scribble a few lines on the APS statement. I’ve asked all of my clients to make sure we have conversations about this issue prior to their next updates. Readers who are managing claims themselves need to exercise extreme caution as well.
Unum’s “Hungry Vulture” reputation is well-earned and all claimants and insureds would do well to insist that treating physicians complete paperwork using my prior posts as an outline.
I’m afraid all disability insureds are facing a risky future for 4th quarter.
By the way one claim with Mutual of Omaha was denied in part because the insured played occasional golf. The information was picked up from a treating physican note describing the activity.
Whether we really think it’s appropriate or not, insureds should be very careful about describing activities to treating physicians. Often times what you say to your doctor is written up in patient notes and you can easily see the result. While patients have grown accostomed to having close relationships with physicians, a better practice is keep your activities to yourself and only discuss your medical conditions.
The claims process is not the same as it used to be. Be careful.
