Ophthalmologists, Orthopedic Surgeons And Other Physicians Who Do Not Support Disability
There are certain medically credentialed physicians that generally refuse to sign disability paperwork certifying patients are unable to work. The top two are Ophthalmologists and Orthopedic Surgeons. These specialities should not be given as “primary” on...
Having A Baby During Disability
Having a baby while receiving disability benefits is NOT a good idea for LTD. While most STD claims provide for maternity leave, it is expected that insured women will return to work after 6 weeks maternity leave. Disability insurers often will NOT take the position...
Working Together To Provide Assistance In Trying Times
For the last several years disabled insureds have been struggling financially to meet obligations given the rising inflationary economy and increased cost of living. Although it’s been difficult for everyone, I can imagine how hard it is for those to live and...
Insurance Medical Reviews-Misrepresented And Biased
Although medical review is perhaps the most important part of the investigation of a disability claim, it is also the most frequently used “stack the deck” procedure initiated by all US insurers, and everyone knows it! That’s right. It’s not as though it’s a big...
Old Rules -More Aggressively Managed
In order to continue to receive benefits in 2023 ALL of the following criteria must be met. If not, claims will be considered vulnerable to risk management and denial. It might be a good idea to consider whether your claim would benefit from an expert. If so, please...
Returning To Work Isn’t Easy
Most individuals who find it necessary to leave work for a medical disability express the desire to return to work at some point in the future. Returning to work is a normal part of our American work ethic, and most everyone believes that returning to work is the best...
Very Unnecessary Claim Denials
Due to the end of the year profitability results I have unfortunately seen several claim denials, which in reality should never have happened. These denials are referred to as “failure to provide” terminations. Insureds and claimants have a responsibility...
Linda’s Christmas Message
Yesterday, I was watching the George C. Scott version of “A Christmas Carol”, and it occurred to me how easy it would be, in our day and time, for people to become a Scrooge of the modern age. Cries of “Are there no prisons?” “Are there...
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...
