Now that we are into the first quarter of 2022, Unum has obviously resurrected its egregious claims practices with frequest requests for more and more documentation. Although the company presents with several administrative problems, such as losing and not updating paperwork received in a timely fashion, the administration still feels compelled to “blame” its insureds because of, well, let’s say unlocated paperwork.
The higher the monthly benefit is (large financial reserve), it appears the more repetitive requests for information there are. My clients with large financial reserves receive by far the more frequent “we didn’t get it” letters from Unum’s claims handlers. This is because managers have “targeted” high value claims and demand claims handlers “stay on top of” what’s going on.
Clearly, receiving requests for same or repetitive information over and over again is frustrating to insureds who just went through filling out forms and visiting physicians. Unum is well aware of that frustration and takes advantage of mistakes that are made because of it. Requesting frequent information is part of the Unum machine and apparently in 2022, the company powers that be have decided to focus on obtaining a great deal of paperwork.
Unum never seems to let go of “high value” claims because of the large contribution to profit that occurs when these claims are denied. The continual harassment, however, gives away Unum’s intent to review claims for the purpoe of denial rather than payment. Oblivious to the giveaway of its intent, the company continues to request medical records every 30 days, which although allowed in ERISA Plans, isn’t reasonable because it creates backlogs for claims handlers. Still, Unum seems to profit from alleged “not received paperwork”, and the requests just keep a commin’.
Unum also uses “paperwork as performance management” to keep its claims handlers in line. Management often requires claims handlers to “touch” claims at least once every thirty days. The dairy system sets up “flups” (follow-ups) that officially document how often claims handlers “do something” on a claim. They can really get into trouble for NOT taking care of their flups when they show up on a daily basis. Claims handlers can use requests and phone calls, as counting toward their “touching” claims every 30 days. But, the opportunity to risk manage high value claims is the primary motivation.
In my opinion, insureds should challenge requests for completed forms and medical documentation if requests are comming sooner than 6 months after being on claim 6 months. I call this the 66 Rule. Most claims handlers opt for a year after being on claim a year as well. It’s OK to challenge frequent requests for information and ask why they are taking place. Insureds with high value claims should accept the fact that their claim will remain on the “target” list for the maximum duration of claim.
