Disability Claims Solutions


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Risk Management2Insureds/claimants are continuing to complain that they are receiving letters requesting information that was previously submitted to the file, in some cases years ago. The harassment coming to light involves the fact that social security, medical and other financial information is frequently requested just because claims handlers aren’t reading the files.

It’s unclear to me whether Unum lost or did away with older files that sometimes can have 2,000 – 3,000 pages or whether claims handlers just aren’t bothering to read anything but the top 10-20 pages of insureds’ files. However, it seems logical to assume that the multiple requests for the same information are coming from some point in a disorganized processing of claims system, that results in multiple letters going out to insureds asking for information that just as easily could have been obtained from the existing file.

In the last decade so much has gone on with Unum as a company that suggests data records may not be available, have been archived, or just plain lost. In one of my past articles I talk about Unum not being able to find lost policy originals and other underwriting information. Requesting the same information over and over again could also be the result of overloading claims handlers with numbers of claims they can’t possibly manage placing time restrictions and backlogs on the staff.

I also suspicion that Unum claims handlers are forced to request SSDI information when in most cases it is sitting in the file. For example, if a claimant has been determined not to have sufficient quarters to receive SSDI and that letter is sitting in the file, why would the claims handler send a letter asking for SSA “appeal” information? Either the claims handler happens to be the “Village idiot”, or he/she didn’t read the file. There is a certain degree of competence that is required from Unum claims handlers, but sometimes I have to wonder.

Quite a few people are calling me with questions about why Unum is asking for the same information over and over again and the reason is most likely the claims handlers aren’t reading the entire file but only the top 10-20 pages of it – the shortest distance between two points! If they are trying to manage more claims than they can handle, management has a backlog problem, something claims managers go berserk about.

In some cases insureds may have to resend the information, but I recommend sending the claims handler searching for it first. In most instances they find it soon enough when they read the entire file.