While Unum Group has been the leader of egregious disability claims practices for decades, a competitor of unfair denials surfaces as Lincoln Financial. This insurance company, according to recent information provided to me, as well as recent experience, now ranks first for unfair claim terminations.
It’s not just that Lincoln often appears to NOT know what it’s doing, it’s also evident the company WILL NOT ABSOLUTELY change its opinion even when it can be proved the company acted in bad faith.
Not only does Lincoln deny claims without full investigations, most notably just prior to profitability reporting periods, the company uses no other back-up excuses other than “our medical reviewers decided…..”. I’ve also found that Lincoln pays little attention to Plan provisions and just does whatever it will take to terminate claims for profit sake.
Apparently, claims handlers are directed not to accept third-party authorizations preferring instead to take up to two weeks to send outside Authorizations to its “legal department.” Seemingly, claims handlers know very little about adjudication of Plan documents and I’ve found the company completely non-compliant with fiduciary responsibilities required under ERISA.
Many claimants are harmed by this company. In fact, after dealing with it for a long time, before and now, there is little I can say that would ever be considered complimentary. Lincoln Financial is a real sham and its claimants are beginning to see that.
One thing about Lincoln that really “tics me off” is that the company documents that claimants should “go back to work on Monday morning.” No insurance company has the authority to ORDER any claimant back to work. No insurance medical resource has the authority to review records and then send claimants back to work. If this were true, I’m sure there would be quite a few dead people because insurance medical resources DO NOT DIRECT THE MEDICAL CARE OF ANYONE. CLAIMANTS ARE NOT PATIENTS. Lincoln has not seen, or treated anyone, and most importantly, does not have complete medical histories on claimants. This is a presumption of medical dictatorship basically saying, “if we tell you to go back to work, you have to go back to work.” Do I really need to tell you this is a bunch of crap? This is what I mean when I say that Lincoln is currently operating outside of any normal insurance review practices.
The only way to try and improve the system is to go back to your employers and tell them about the claim abuses (assuming you know) and insist that the company find other insurers who would be more objective and rely on medical evidence. Again, this assumes the employer is interested in treating employees fairly rather than opting for the more cost effective (cheap) coverage.
Please know that if you have a Lincoln claim you’re going to be in for a difficult ride. As a Consultant, I also recommend that you notify your state DOI and ask for a “Conduct Market Examination” of Lincoln’s claims practices. Although the DOI doesn’t have jurisdiction over an ERISA claim, you can make the request. I’d also notify your local EBSA regional office of the US Department of Labor and report them. This is the Federal Agency that has jurisdiction over ERISA claims.
In my opinion, Lincoln is bad news folks, and you should be prepared when you begin to see claims practices outside of your Plan provisions.
