I am writing this article to re-emphasize that although insureds are scared and are, in some cases, demanding that the claims process move forward as usual, everyone seems to be biting at the same pickle, including insurers.
The United States has not had to go through a national pandemic like this, (at least in my lifetime), so procedures, safety measures and functioning are all new. Insurers are struggling as much as any small business to keep things running – barely.
In the last two weeks I’ve spoken to every insurance company and they are telling me claims personnel are working at home the best they can without resources. Information is not being processed on a timely basis. Some insurers are asking insureds not to use emails, and only fax information to designated numbers. Employees are only required to check their voice mail once per day.
In the meantime, insureds are so fearful in some cases that they are actually attempting to obtain medical notes and signed update forms from physicians who have also sent employees home and closed their doors to patients. Demanding claim results just prior to the 1st Qtr. profitability end was hard enough not to mention the disorganized state currently going on.
I’m currently seeing a great deal of anxiety about deadlines, paperwork, completed forms etc., when it is unlikely the information will be reviewed in a timely way. One claims rep told me that he wouldn’t see a fax for more than four days!
Therefore, I’m recommending that insureds take a deep breath, and to the extent possible, calm down a bit. My recommendations in prior articles have focused on COMMUNICATION, (in writing of course), informing insurers about treating physicians and inability to obtain records.
My guess is that if insureds are under self-isolation, social distancing, or quarantine, they aren’t functioning very well either. Imagine what’s going on inside these big insurance companies when most employees are working at home. The claims process WILL NOT BE GOING ON AS USUAL, and you will need to work within the current situation.
I can honestly tell you that in all of my recent communications on the phone with insurers, I have found that claims handlers have adopted a more “concerned” and “humanistic” attitude since they themselves are in the same boat. They have all wished me and my clients safety and good wishes; and, I’ve done the same.
The real problem is what to do with insureds who are so panicked about benefits that they are stressed out demaning answers and decisions that will not be forthcoming as early as expected. And yes, some checks are late. Unum seems to be the culprit, as usual. But, in all cases I’ve inquired about, the checks are LATE, not BENEFITS DENIED.
We are all dealing with situations that are unprecendented. Let’s everyone work with what we have, communicating your particular situations when required, and have a bit of calming common sense toward what is happening within the administrative processes of these big insurance companies.
Most Americans are struggling and claims decisions are just not going to go as planned for awhile.
