Disability Claims Solutions


Give Linda a Call

Stupid PeopleIt came to my attention the other day that Prudential is scheduling IMEs in October. Personally, I have no idea what management is thinking since not even Prudential has a crystal ball as to what will be happening  3 months from now.

It may be that management is forcing claims handlers to “touch” claims now so that they do not lose control of the claim and create backlogs in the future. You may recall in some of my other articles that “backlogs” are near death experiences for insurers and they avoid them at any cost.

It’s my guess the country may be locked-down until after the election and it may be that the very IME physicians being scheduled today may not be available in October. It’s important that we try to “see through” what the real motivation is. Thinking logically, it could be that Prudential’s management is creating activities for claims handlers working remotely to keep them busy.

Whatever Prudential’s intent is, if you receive a notice for an IME in the distant future, take it with a grain of salt. I would also add, that if it were my claim I would make very sure my file was updated with new medical every time I saw the doctor.

I have to say, though, that scheduling an IME three+ months in the future is not realistic and is being done for motives other than “clarifying medical restrictions and limitations.”

Also, Prudential has always been the one group insurer who misrepresents mental and medical notes to the greatest extent possible. This is why the company insists on receiving actual psychotherapy notes rather than completed forms so that it can, very cleverly, “interpret” the information in its own favor.

For this reason, DCS never has recommended that claimants provide Prudential with therapy notes since the interpretation of them often sounds as though it came from another claimant’s records. Prudential’s interpretations are very deceptive and is often write-up by RNs who have no experience with mental illness.

Finally, Prudential still uses medical reviews written by the old “claim killer” physicians from years ago. I don’t want to mention their names publicly, but many physicians who used to work with Unum are still out there doing medical peer reviews for Prudential that are just as harmful to insureds as they always were.

Those with Prudential Group claims need to pay particular attention to mental and medical patient notes, and doctors hired to do peer reviews. These are definitely areas in which Prudential seems to excel and cause the most harm.