When Do Disability Insurers Cross The Line?
All disability insurance companies have the right to fully, and fairly investigate the facts of claims submitted to them for payment. The insurer also has the right to conduct surveillance and to make sufficient inquiries in order to determine insureds inability to...
A Word About Malingering
The definition of malingering as defined by most disability insurance companies is: “the deliberate exaggeration of psychological and/or physical complaints for purposes of tangible secondary gain.” (i.e. monetary rewards, etc.) According to the organizations who...
Advance Pay And Close – A Likely Scheme
Most disability Claims Manuals state the following: “An Advance Pay and Close is a claims management tool designed to help an insured return to work when there is a reasonable and expected return to work date/plan. By offering an alternative payment method, we are...
The Christmas Grinch
I wanted to briefly remind all of my readers and clients that disability insurers are out there conducting surveillance through the new year. More than that, they are likely conducting Internet social media by peeping wherever you have a presence. Please avoid the...
Insurance Neuropsychological Evaluations – Biased
Neuropsychological tests, or (Neuropsyche for short) are tests often requested by insurers as Independent Medical Evaluations for mental health claims. While they aren’t quite as popular today as in the past due to their cost, claims with wealthy benefits...
Year-End Profitability Denials – A Real Reality
Here we are less than a month before “year-end profitability” results for all US insurers. Although all claimants and insureds depend on their monthly benefits for financial support, I’m sure they don’t realize each year, “how close they...
MetLife – But No One’s Home……
Just when I think I’ve heard of everything I leave it to MetLife to change my perspective. I was told by a MetLife supervisor that management has told all claims handlers not to answer their voice mails or return calls. Apparently, they are too busy. In...
That Ship Has Already Sailed
In the last week alone I had three calls from claimants with denied claims looking for assistance. However, Consultants (by the laws in their states) do not have the option of taking on appeals and settlements – a concept I agree with. ERISA and IDI appeals are...
Unum’s Claims Handlers – Definitely Not The Sharpest Knives In The Drawer
Lately, insureds are reporting to me what Unum Group claims handlers are doing to delay payment on claims. Most of it, to be honest, is a bit silly, and yet it is frustrating many claimants with positive insurance company results. While it’s not unusual for Unum...
Insurance Advocate Consultant – What I Do
I was recently speaking with a friend who is a professional Business Advisor, now disabled for many years. After visiting my website and Lindanee’s Blog, he suggested that perhaps I don’t spend enough time explaining who I am as a person, or what...
Insurance Musical Chairs
Disability insurance companies aren’t very good at retaining employees for very long. I’ve found that once most individuals find out that the job of a claims handler is not “quality claims management” but denying claims, they leave in droves....
Are “90 Codes” A Unum Issue Again?
In speaking with several of the attorneys I still have professional relationships with, it may be possible that Unum is using a tactic it used in the past to deny claims in one period by deleting them from the system, but not having sufficient proof until later...
To A Dear Former Client
Yesterday, I received a call from a former 2005 client thanking me for assisting her with a MetLife claim that is now nearing the maximum duration of claim because she is turning age 65. The recollections of this dear woman and what transpired in her life over the...
The Hungry Vulture Is Coming For Your Claim
Well, it’s that time again and the “Hungry Vulture” is alive and well at Unum Group. Most of you probably aren’t aware that the “Hungry Vulture” logo was given by claims handlers from the old Paul Revere and Provident companies...
Making Healthier Choices From Research
In recent years, one of the good things COVID probably brought to everyone’s attention is the importance of good health with a viable immune system achieved by consuming “clean food”. Although the American system of labeling contents of our food...
Living With A Disability Claim – Why Won’t People Believe Me?
You stand in front of your mirror and carefully examine every part of your body. You appear normal, you do normal things, you can even continue most of your activities of daily living. And, you think to yourself, so that’s why my family and friends don’t...
Unum – What The Heck?
Unum has been chasing SSDI award information for many years, and by as many different ways and means of dishonesty or misinformation. Many third-party “paper chasers” have been employed to assist the company in obtaining usable information from SSDI files....
When Does An Insurer Cross The Line?
All disability insurance companies have the right to fully, and fairly investigate the facts of claims submitted to them for payment for the policies sold. The insurer also has the right to conduct surveillance and to make sufficient inquiries in order to determine...
Bye, Bye Newsletter
Recently, I sent word out to my clients that I would be discontinuing the DCS Newsletter emailed to them every month. In recent years The Newsletter seemed to be getting very little readership. Further, some clients reported to me that they felt the information was...
Major Hurdles To Managing Claims
Given all of the disorganization of disability insurers due to COVID, lack of communication and any semblance of Customer Service is by far the major hurdle to successfully managing disability claims. Despite the fact that in the past all insurers prided themselves...
