Yesterday I was speaking to a DCS caller about a claim situation in which Unum denied her claim twice, finally overturning the appeal and paying the claim “because she was awarded SSDI.” In the course of the conversation, I inquired about why this claimant relies so heavily on such an uncertain, and shaky financial benefit that can be denied at any time.
“Did you not realize that Group STD/LTD plans are written against you from the beginning and that the income should never be relied upon? Did you get a copy of the Plan, read it and understand how insecure the benefit would be?”
“No”, to both questions. She went on, “I trusted my employer that these benefits wold be paid to me, and besides I never thought I would ever become disabled.” And there you have it – misplaced trust in the uninformed word of an employer that these benefits would be paid in the event of a disability, AND a belief that disability “just won’t happen to me.”
“Did you at least ask for a copy of your Plan so you could read it and understand what you would be entitled to?”, I asked. “Did you not understand how uncertain these benefits were going to be?”
“No”, again, to both questions.
I have been writing informative articles about Group STD/LTD policies for 25 years now, and to be honest, I’m getting a bit weary. Although my journalistic endeavor began at the same time I started DCS, Inc. with articles in Jim Mooney’s Newsletter called, “Inside UnumProvident”, it doesn’t seem to me that my articles have changed anyone’s perception about Group STD/LTD in general, still relying on benefits that may not be there.
So, let me be clear…….Group STD/LTD claims can be denied at any time at the insurer’s “discretion.” Although this statement is really the answer to all those questions about, “Why doesn’t my insurer believe my doctor”, and “How can Unum deny me when I’ve submitted so much evidence?”, most people still won’t get it. In fact, the above statement is an accurate description as to what the insurance product of Group STD/LTD is really all about.
I also noticed the stats on Lindanee’s Blog seem to favor articles such as, “Resignations”, “Where’s My Check?”, and “How can I pass an FCE?” instead of more important articles about “How to Medically Document My Claim”, or “Writing Good Restrictions and Limitations.” Despite the fact that these articles are much more important in supporting claims, the readership is very low.
Stats show my articles concerning “how to” fully document and prove claims are the least read in lieu of articles that might be interesting, but not essential to the claims process. What are people thinking these days? Articles I wrote concerning financial planning are not read very much either. It does make me wonder.
Most importantly, why are claimants still depending 100% on benefits that can be stopped at any time for financial support? Do you not realize that group insurers can deny benefits solely at their discretion as long as the review conducted is not later determined to be “arbitrary and capricious?”
I guess there really is “no rest for the weary” when it comes to disability claims. I really hate to see claimants depending so heavily on benefits they may have today, but not tomorrow. The truth 25 years ago was that Group STD/LTD benefits should not be relied upon for future financial support. That same truth exists today, but it seems as though more people than ever are relying on uncertain benefits as their sole support.
I suppose I’m just tired of writing about it. “Forewarned” clearly may not be the answer.
