Although there must be at least twenty or more articles on this blog about the negative effects of “fear” in managing disability claims, I’m hearing more and more from insureds who are again finding themselves in paranoia mode asking me if they should do things that, frankly, they should never do.
I realize that the entire world right now is living in fear, but when it comes to disability claims, “fear” is an enemy no one can afford. Therefore, although this article might be somewhat redundant, I have new people reading it every day, therefore I should repeat tips and suggestions for curbing “fear” about the uncertainty of future income.
For those on claim, “fear” comes from the idea that insureds are no longer in control of their income. It is true that anytime someone else controls your money, they also control YOU, whether it be the government, a spouse, a parent, or a bank; if someone else controls your income, they are also controlling you. Withholding much needed funds to pay bills, prescriptions, and health care, will cause any otherwise rational person to do almost anything, even when the request is unreasonable.
This is the situation that people on disability find themselves in. Already vulnerable due to physical/mental illness, most people will “obey” and provide any request from an insurance company, not realizing there is no guarantee of continuing benefits, but a risk of “misrepresentation of facts” that can always be pulled from the insurer’s scalp belt at any time.
Insurance companies have known for a long time that the more they can get insureds to “talk” and/or provide unreasonable information about their lives, the more they will always dig themselves into a bigger hole.
Let me give you an example. Last week someone called me to ask if they had to sign Claimify’s SSDI Authorization and if Unum could “deny” her claim if she didn’t sign it. I want to be very clear on this issue. Claimants’ and insureds’ ERISA Plans and Policies are the first and only direct source of information for questions such as this, as well as many others.
No where does it say in any ERISA Plan on this planet that claimants MUST sign a SSDI Authorization to release SSDI files as “proof of claim” before benefits can be paid. No where does it say that……no where. So why does Unum keep asking to release SSDI files? and why are claimants so fearful when requests are received?
Here’s the answer:
- Unum is required by the Multi-State Settlement Agreement to “consider” SSDI decisions. (Notice the requirement uses the word “consider” only.)
- Unum is looking for Form 831 that discloses the “listing” under which applications are approved. If the listing is “mental and nervous”, or one of the listings, Unum uses the SSDI award to justify limiting benefits to 24 months.
- In the last several years, Unum is looking to perpetually re-calculate overpayments and allege claimants “owe Unum money.” Although Unum refers to the requests as “routine” claimants are under no obligation to release SSDI files.
- In some situations Unum has used the name of the SSA DDS (Disability Determination Specialist) as a contact to obtain information about you, but only if you signed the Authorization. No one should do this.
Since the only relationship between claimants/insureds and their insurers is what is in their Plan or Policies, claimants can easily READ their Plans and find answers that will calm them down and reduce anxiety. Simple questions such as the above can be easily debunked once claimants actually read their policies.
Best advice? Never let fear or claim paranoia drive you to do things your insurer is requesting when it is out of Plan or Policy, and/or is unreasonable or burdensome. People who are driven by fear will always act in ways that are against their own best interest.
Fear that an insurance company will deny claims is NEVER a good reason to “give in” and do what you’re told. Read your Plan or Policy, check it out, ask questions, ask for the request to be explained in writing. There is nothing wrong in putting this in the record, “I acknowledge Unum’s request for me to sign an Authorization giving Unum permission to obtain my SSDI file. However, as is my right under HIPAA I wish to designate my SSDI file as Private Health Information (“PHI”) and respectfully decline to sign this Authorization.”
And, “No”, Unum can’t deny your claim if you don’t sign it because your policy doesn’t require you to sign it. If you’re still scared about the request, “that’s fear talking”, not your Plan or Policy, nor is it using common sense.
I have always found that those receiving disability benefits are stronger and more emotionally equipped than they often think. No one receiving disability need be a victim. I always tell my clients, “We can’t control what any insurance company does, but we surely can control what we do.”
Empowering yourselves to retain control of your claims is the first and most important step to reducing fear when receiving money from a third source. Read your Plan or policy, and maintain compliance under its terms.
But, never allow an insurance company to put you in a “state of fear”, so much so, that you act impulsively and don’t think things through.