Insurance companies clearly are not operating in any organized, centralized way. The disability claims process, whether we like it or not, has evolved into a totally disorganized “cluster-duck” in most cases, not even primarily located in the United States.
For whatever reason, and I’m guessing it’s financial, disability insurers have opted for “offshore, remote employees that haven’t the foggiest idea what they’re doing.
For example, yesterday I attempted to contact the Unum Financial Services Unit to assist my client with the repayment of a SSDI overpayment with a lump sum settlement. After a half hour trying to reach the one person who could help us (she was not in the office), I was connected to someone in South Africa. What struck me was that this woman had no idea that repayments could be made via settlement, nor did she acknowledge that she knew SSDI deducted attorneys fees were indicated in the Award Letter.
I decided to take another tack, and asked “to speak with someone in America.” I was immediately connected to an “onshore” Customer Service Rep who knew a little bit more about what I was talking about. I was told my client’s rep was “onshore” and would get back with me today.
What was really spooky was that it sounded as though both reps were clicking via a phone relay system that made a sound (loud beep) each time the conversation changed from one person to another. The entire phone call was very, very strange and I almost felt the need to say, “Over” when referring back to the rep.
I’ve known for quite some time that Unum, and other insurance companies were using “offshore” resources to management claims. Just a month ago, I spoke to someone in the Philippines, and that’s not necessarily wrong. During my call, the rep in South Africa excused herself frequently to find out answers to very simple questions. It was obvious the “offshore-onshore” process wasn’t working, and the rep was befuddled by every statement I made.
What really bothers me about this is that the individual reps I’ve spoken to, know absolutely nothing about disability insurance, nor any of the components of managing disability claims. The lack of any credible type of customer service, including resources that can manage claims proficiently, is against the law in those states that require competent insurance resources to manage claims.
What this means for insureds is that since insurers are unable to manage claims in a “good faith and fair dealing” manner, insureds and claimants will need to to manage things themselves. Phone conversations aren’t the way to go, because the reps are “brain dead” for all intents and purposes. Too bad, Unum, but you get what you pay for.
My suggestion is to communicate only in writing, and for 2024, make sure every thing is added to your file. If you need to go to court, the judge won’t be in South Africa, and your claim can be easily explained just by reading what is in the file. This is, of course, assumes employees know enough to put information IN your file in the first place. It would be a good idea for all insureds to keep and maintain their own files, create time sensitive journals, and manage claims themselves.
Also, don’t be afraid to ask where the rep is physically located, and document it. It is perfectly fine to ask to be connected with a rep who is in the United States since they know more about the claims process than “offshore” employees.
Please do not trust the claims handlers on the phone; they just have no idea what to tell you.
