Although Unum Group is publicly known as the worst “bad apple” company in America, Prudential Financial and Lincoln are the runners-up that we don’t hear too much about. I’m already hearing case scenarios that indicate to me these two additional companies have jumped on the “egregious claims practices train” and are also denying legitimate claims.
In my opinion, Prudential has always been an egregious disability company, having quite a few claims review practices that are definitely in violation of “fiduciary duty.” Its claims practices are second only to Unum; and, the company definitely has a public reputation of violations of “good faith and fair dealing” standards.
One of its most outrageous claims practices is that it utilizes RNs to conduct medical claim reviews in lieu of qualified physicians. These nurses have no specified specialties in certain impairments, and clearly are sub-standard reviewers of medical information. When you consider that many disability claims involve high-value financial reserves hitting 1M or more, having a RN review claims is like having a High School graduate review data on which someone bet millions of dollars.
Prudential, is by far, the top company that consistently misrepresents mental and nervous information from patient notes. In this respect, the company is rotten to the core. (Pun intended.) It is also the one company that will deny claims if therapists refuse to provide actual psychotherapy notes (even though they don’t have to). I have probably read hundreds of Prudential’s medical reviews (by RNs) where the slightest mention of “patient is doing well”, or, patient is somewhat better, was used to deny claims.
Prudential also has several tricks up its sleeve such as denying STD in the 24th week of STD and then alleging the claimant didn’t meet the EP for LTD. What a manipulation that is! Again, in my opinion, Prudential lacks credibility for its medical reviews, interpretations of patient notes, and “tricks” of manipulating timelines.
Lincoln, right now, is operating in its own twilight zone applying Plan provisions it knows nothing about. Personally, I believe the company is third in line for unfair claims practices, mostly because it keeps alleging it didn’t get information faxed, emailed or sent by insureds. If its internal paper machine is that bad, then it needs an internal do-over of its communication center. In the meantime, claims are being denied for no legitimate reason.
Just wanted to remind readers that Unum Group isn’t the only “bad apple” in the barrel. There are many others out there doing basically the same things to NOT pay claims.
