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Unum – And The SSDI Scam Continues….

 

Unum has currently changed its SSDI template letters to encourage claimants to submit SSDI files without question. DCS, and this blog frequently reminds claimants that Unum often does not ever tell the truth about why they have such an interest in SSSDI files.

Unum’s current change to its template language is obviously intended to convince claimants Unum has their best interests at heart. The new language is: “Once we obtain your Social Security claim file, if appropriate, we will apply significant weight to the Social Security award of disability benefits. Significant weight means that the Social Security’s judgment that you were disabled at the time of the award will weigh heavily in your favor as we make ongoing disability determination under your Long Term Disability policy.”

Of course, the key terms and phrases here are “if appropriate”, and “judgment that you were disabled at the time of the award.” Claimants should already know that there is no requirement compelling them to hand over their SSDI files as “proof of claim.” Therefore, claimants can refuse to release their files and there’s nothing Unum can do about it.

So, why does Unum want to get their hands on your SSDI files so urgently? First, Unum is interested in checking Fed Form 831 to find the listing codes under which SSDI was awarded. The major draw are mental and nervous listings, since Unum will want to limit benefits to 24 months. The 831 also gives the name of the DDD or claim determiner. In the past, Unum was found to have abused such information by contacting the DDD directly without permission.

And, of course, it does not escape me that we are only 3 days from the end of the 2d quarter and Unum is all excited to shorten or end benefits before then. I’ve seen a lot of these same letters going out. The third reason Unum wants SSDI files is to obtain financial award information so that it can recalculate and recalculate overpayment figures alleging new overpayments again and again, nickel and dimming claimants for profit.

I’m hoping Unum isn’t really fooling anyone with this new “significant weight” sham. For over 25 years that I know of Unum has played the same cards with respect to getting SSDI files and using them against claimants. While Unum IS entitled to the SSDI Award Letter so they can set up the offset and collect on any overpayments due, it is NOT automatically entitled to a copy of the ALJ award letter or anything else contained within the SSDI file.

The reason why so many claimants are fooled by Unum’s attempts to portray a “nice guy persona” is that they are scared Unum WON’T give them “significant weight”, or that benefits will be denied if they don’t turn over the SSDI files. Unum cannot deny benefits for failure to provide something that’s not required to be disclosed in their Employer’s Plan in the first place.

Furthermore, Unum isn’t stupid, and here is where the sham thickens. First, Unum requires an IME, which of course comes back in its favor. Then, Unum denies the claim because, “…we now have information that SSA didn’t have at the time of the award. Therefore, we disagree with the SSDI approval determination and therefore your claim is denied.” Clever, huh? Is this what Unum means by significant weight?

With respect to SSDI, Unum is always looking for approvals, offsets, overpayments, or M&N listings since all three decrease financial reserve and provide hits to profitability. Please believe me when I write that there is NEVER a Unum “fiduciary, or, in your best interest” intent to do anything. It’s all about the profitability, and Unum does not provide claimants with its true intent when requesting SSDI files. Period.

Before deciding to turn over your SSDI files to any insurance company, please consider the intent for requesting it. If it isn’t in your best interests, you can just say “No.”

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