Here we are on the precipice of Christmas and a new year, 2021. The year 2020 was indeed a challenge with COVID and the uncertainty that went along with it. From a private disability perspective, many of the internal COVID procedure changes had already been taking place, such as the outsourcing of the claims process and hiring remote employees to manage claims.
Early in 2019 – 2020 most insurers opted for cheaper services and less fixed cost overhead to implement claims process procedures. Companies such as Unum Group did away with entire departments with frequent employee terminations and firings to the point that it would be hard to say any insurer really maintains a “campus” anymore. Decentralization was a 2020 priority, and now most private disability companies are “spread out” geographically with minimal central leadership.
As COVID became a national “pandemic”, and physicians began to make use of Telehealth and other IT medical consultations, it became the norm for physicians to “see” patients telephonically. The costs of Telehealth medical consultations were supported by Medicare and health insurers ultimately opening up care to patients with minimal contact involvement.
As a result of the changing tide of claims management, I wrote several articles for Lindanee’s Blog describing the “new normal” for working with insurers through heavily insurance guarded proof of claim provisions. I described “the new normal” as a phenomena created and utilized by insurers. In retrospect, I was wrong and never could have anticipated COVID, or other changes made in the claims process to keep our people safe.
Currently, I am of the opinion that with respect to managing private disability claims, insureds should make their own “new normal” claims process, replacing anxiety and fear with personal empowerment and “action” in order to continue to receive benefits.
In 2021, I predict, as COVID winds down (hopefully), that insurers will once again tighten their claims requirements in order to recoup financial losses taken in 2020. However, I do not expect the claims process to ever go back to what it was as a micromanaged, centralized process since insurers have already “dug in” to decreased employee and fixed cost reductions.
Failing to return to “campus oriented” claims processes, companies will become more and more inefficient – can’t find paperwork, late decisions, requests for information over and over again, misinformation, etc. Therefore, insureds are recommended to seek information and be willing to endure more frequent inefficiency and negligence.</p.
I also project that physicians will continue to utilize Telehealth as long as Medicare and health insurance covers it. However, I also note that more and more physicians are rejecting patients because they do not want to be bothered by endless paperwork. During 2020 I also heard from physicians themselves they are fearful of lawsuits and spending a great deal of time with disability forms. One physician shared with me, “It’s actually cheaper for me not to accept private disability patients given the excess amount of time I have to spend on reporting versus fees I charge for office visits.”
It is likely in 2020 insurers will increase referrals for IMEs and surveillance, which now includes Internet snooping on social media. Since the courts have upheld the right of insurers to use information obtained from social media, all bets to privacy are off and whatever goes on the web will be used by insurers to discredit claims.
Therefore, 2021 may well turn out to be a hard year for insureds, but it will be less so IF insureds make it their business to read their Plans and policies and be willing to put with the, uh…..bull chit. Sorry!
Merry Christmas to all. It is my hope that all of our people stay well and safe. 2021 can be very promising for insureds if they stay on top of what’s going on with their claims.
