Disability Claims Solutions


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cahsing the money2For the last several years Unum Group has been extremely aggressive in “correcting”, recalculating, and estimating SSDI benefits in an effort to bolster profitability. Hiring Lucens and using Genex as its third-party paper chasers, Unum’s procedures to record offsets and recapture overpayments has also been….let’s say questionable.

A good case in point is that of a single mother with two children who was recently awarded Primary SSDI and was required to file separately for her two children. Due to government delays because of COVID, the dependent awards, according to SSA are delayed.

In complete disregard of this mother’s financial situation Unum “estimated” the dependent awards, reduced her benefit, and then further reduced her benefit to $0 as a punitive measure for not paying back the retroactive SSDI award, even when the claimant had not received it yet. This mother has been “punished” by Unum for circumstances beyond her control. After all, you can’t give back what you do not yet have.

Just 15 days or so before the end of 2nd Qtr. Unum’s “tactics” are deplorable. Coincidental? Not hardly. Once estimated benefits are coded into Unum’s pay system, the financial reserve is reduced and an immediate contribution to profit takes place. The timing of Unum’s increased unfair tactics is a dead give away as to the company’s motives.

What Unum did to the above insured was violate the conditions of her Plan where it is written that if she continues “the SSDI process” no estimates would be taken. Applying for dependent awards IS “part of the process” and Unum violated the conditions of the Plan by taking the offsets. Reducing benefits to $0 to recover a not-yet-received overpayment is just plain nastiness on Unum’s part.

I think Unum’s actions are further evidence that Unum is capable of using out-of-contract strategies to profit financially at the claimant’s expense. I’m almost sure other claimants have been the victim of “Reservation of Rights” status in order to bolster Unum’s 2nd Qtr. profitability.

I think all in the industry would agree that as a company Unum is worse than it has ever been.

In comparison, The Hartford’s employer ERISA Plan offsets many more items than its competitors, such as COLA increases and other income. Recently, a claimant reported that The Hartford included “Veterans Disability” as Other Income and since he was eligible to receive it, an estimated offset would be taken.

Again, we’re seeing “estimates” for additional income taken in order for Hartford to increase its profitability. While I’m not surprised at The Hartford’s strategy to record offsets, it certainly doesn’t help claimants, and in fact, some would say these types of financial policies go overboard to intentionally “harm” claimants. I would agree with that.

It may be time for claimants to challenge insurer strategies to “not pay what is owed” by taking estimated offsets before overpayment money is actually received. These practices are in fact out-of-Plan and all benefits should be restored plus interest and damages.