Disability Claims Solutions


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Why am I not getting any update forms and checks on time?

Insureds continue to think that insurance companies are operating under maximum efficiency when they definately are not. Not getting expected annual update forms and/or benefit checks on time is scaring quite a few people. But, let’s try to remember that insurance companies, like all other businesses are still trying the best they can.

Insurance companies are probably more inclined to remain disorganized, since most of them had already lost control of the claims process before COVID. However, late checks and delayed requests for updates are normal and customary these days. It’s all a chaotic mess, and the important thing is for insureds to work with the process and the system. What I’m seeing now across the board is repeated requests for information previously submitted, Unum late checks, and lack of customer service contact. I do have to say, however, that MetLife’s representatives have done extremely well with trying to help claimants while correcting their own errors.

What do I do if my doctor’s office is still closed and I’m being pushed by my insurance company to obtain records.

Insureds cannot provide what they do not have access to, nor can insurance companies obtain what is not available. The important thing is to communicate with your insurance company, making sure there is documentation in the file indicating that neither you nor your physican can provide records at this time. This is the best thing to do.

Are insurers punished for violating ERISA?

Unfortunately, “No”. Twenty years ago many federal judges held insurers accountable in their decisions, but no more. In fact, there does not appear to be a universal concern anywhere that insurers are acting in criminal ways to deny claims. For example, Unum and CIGNA continue to violate the terms of their Multi-State Settlement Agreements in which there are added monetary penalties for violations. Given the world we now live in, insurance contractual violations and unfair claims practices are a mere pittance in comparison to worldwide events.