Physical and mental “functional capacity” is quickly becoming the major determination factor to make benefit decisions regarding claims. While treating physicians are more reluctant to certify to “functional capacity”, insurers are putting...

Pointing to yourself Unfortunately, the disability claims process is an industry where, “it’s better if they don’t know your name.” In other words, “no news is good news”, and let’s not poke that bear. It’s far better...

Those with disability claims should always be “guarded” in conversation, particularly when speaking to treating physicians who report to insurance companies. In December, I read at least two denial letters citing activity and travel obtained from patient...

Happy New Year! As part of the new updates planned for DCS in 2022, I plan to update my Disability Claims Solutions website located at: http://www.disabilityclaimssolutions.com to include the library of authored articles I’ve written over the last 25 years. It is...

Although most disability insureds may be thinking today, “So where do I go from here?”, the obvious is to “tread carefully.” Clients notified me that even on New Years Eve, Unum contacted its insureds supposedly for an interview. We know the...

The title of this article refers to the actor Sam Worthington’s famous words, from the movie The Texas Killing Fields, “My pappy used to say, “Sometimes you git, and sometimes you git got”. While the euphemism from the Deep South might have...

There have been so many inquires to DCS lately regarding a company called “Claimify” that I thought perhaps it would be good information to include a blog on the subject. There are so many companies out there now that are hired to be “third-party...

Although I haven’t been aware of Unum’s occupational targeting in a long time, I received three phone calls this week from insureds, all Nurse Anesthetists with claims managed by Unum. Complaints center on harassment such as frequent phone calls and excess...

Twenty years ago inssurance companies took big hits to their public reputations when “bad faith” and unfair claims practices were disclosed to the general public. Attorneys crawled over each other to make millions on bad faith, and many of them did. Since...

Unum’s operations for short-term disability have obviously gone from very bad to worse. Twenty years ago, the company made a decision to throw STD claims management in with other products such as LTD, and it’s been downhill ever since. (This is a story in...

Most of the information on the Internet pertaining to disability claims management is negative and discouraging. However, today I’d like to write about some of the positive reinforcement actions insureds can put in place to help themselves have a better time...

  All disability insurance companies recognize profitability by reductions in financial reserve. That said, year-end targeting of vulnerable claims is perhaps one of the most important priorities of an insurance company from October through December. The process...

As most ERISA claimants know, Employer Group Plans nearly always contain a definition of disability that includes the following: “After 24 months claimants must be unable to perform the material and substantial duties of ANY occupation for which [the claimant] has...

In the past, I haven’t used Lindanee’s Blog to market my Consulting Services although several insureds lately suggested that I should talk more about the successes of DCS and the numbers of clients still receiving benefits after receiving my help. My...

  Anytime “insurance” is paying a benefit you can be sure that “profitability” involving financial reserves are involved. We are slightly under two months to year-end and already I’m dealing with insureds who are battling Unum to...

The tendency of insureds to claim multiple diagnoses and co-morbidity for disability purposes is often a self-inflicted risk to denial. While it is possible for insureds to have more than one diagnoses, there is a point of “reasonableness” that will be...

An insurance “field visit isn’t exactly good news. Or, it wasn’t good news before COVID when insureds were asked to meet person-to-person for what was internally managed as “in-person surveillance.” While requests for field rep interviews...

Late Checks It’s that time of year again when insurance companies begin to act irrationally evidenced by error after error after error. Insureds, exclusively from Unum, are already starting to report that their benefit checks are late. Traditionally, Unum has...

Statistics published by the Health Insurance Association of America (HIAA) report three out of ten American workers file disability claims before retirement. Of the thousands of disability claims filed in the United States, excluding Social Security, approximately 40%...