Who Are The Claims Handlers And What Do They Do?
In today’s terms, insurance claims handlers are really not “specialists”, but are considered bottom rung glorified Administrative Assistants, hired for the sole purpose of chasing paperwork and routing files back and forth among resources. Claims...
Is Your Doctor Becoming Troublesome?
The new normal, “after COVID”, seems to be driving disability physicians to tighten-up their support, and the manner in which they choose to support claims, and not in a good way either. Physicians are more cautious, skeptical, and selfish about the...
Hungry Vulture 2d Qtr. Profitability Results End of June
I just wanted to send out a reminder that the end of June is the end of the 2nd Qtr. profitability results for insurance companies. This means there are organized efforts to locate vulnerable claims, and conduct investigations to create the illusion that claims should...
New Fee Structure Reflecting The Times
I wanted to remind my readers, and in particular those who are looking or needing help with their disability claims, that I offer new insureds the option of paying my annual fee on a monthly basis. It has always been my practice to offer insureds the option of paying...
Summer Surveillance
Surveillance in one of those insurance investigative actions that does not require insureds to do anything wrong. It is an interpretative risk management activity insurers use to identify “inconsistency of report” between R&Ls reported, and observable...
A Unum Issue – Regular And Appropriate Care
Prior to 2000, Unum’s Group Plans and policies were issued from a category referred to as “XL” or “XLL”. These Plans lacked clarity and resulted in Unum’s infamous “blue memos” directing claims handlers to deny claims...
So Where Do Disability Insureds And Claimants Go From Here?
Disability insureds have seen tremendous changes concerning the manner in which insurers review and pay claims. While the majority of change was due to COVID and the necessity of handling increased claims without mounting losses, the truth is that disability...
A Unum Blast From The Past – 1994-1996 History
From 1994-1996 Human Resource functions were split between two separate departments—UNUM America HR (payroll, and all HR functions for non-executive personnel), and Enterprise HR (HR functions relevant to the CEO, Jim Orr III and the top 26 Senior Vice Presidents.) I...
Can Anyone Help Me? by Linda Nee
Can Anyone Help Me? Martha kissed her two small children goodbye and watched them closely as they ran toward the school bus, lunch boxes flailing, backpacks slipping off their small shoulders. It was a beautiful day in rural Maine. The sun glistened through the...
When Insurance Companies Cross The Line
All insurance companies have a legal, contractual accountability to perform all duties under the terms of the policy and to pay those claims that should be paid and deny those claims that should not be paid. In the performance of these duties all insurers are required...
Disability Management Services – Can We Call “A Thing, A Thing”, Please?
Disability Management Services, or DMS may be playing a “word game” that could cost an insured $1M in lump sum disability payment. As third-party adjudicators of Lloyd’s of London insurance the company has a strategy hook I think insureds need to...
Guardian Has Gone Rogue – Unfair And Untimely
Those who are waiting for Guardian to make swift liability decisions, may still be waiting a year from now. Since the Berkshire/Guardian merger some time ago, the company evolved into a paranoid, confused, over-investigative resource that is causing havoc with...
Felony Conviction For Stealing Business ID
I just wanted to send out a message to the person who hijacked my business contact information and has been sending it out to franchise list servers. In addition, you’ve been contracting businesses in my name in the Portland area by actually inputting requests...
Prudential – A Real Piece Of Work
If someone were to ask me today which insurance company was the worst for disability insurance I would have to say Prudential. While most insurers at least attempted to accommodate and act humanely during COVID, Prudential did not. Staffed with former Unum employees...
Farewell To The Unum Facility in Portland, ME
Although I have been posting that Unum no longer has a centralized facility, I didn’t know until today that Unum’s main campus in Portland, ME is now the Berry Dunn buildiing. Those of you who have been to Portland, ME on outer Congress Street may have...
Divorce And Disability Claims
Unfortunately, the divorce rate for disabled insureds is greater than the 50% cumulative rate for couples in the United States.Those who are most vulnerable in our society are often left behind when non-disabled spouses fail to cope with their care-giving roles....
Hello? Hello? Is Anyone There? Happy Holiday.
Have you tried to reach your claims handler recently? It’s as though all claims specialists suddenly went DOA, or took a trip to East Gish somewhere. (East Gish is an imaginary place in Maine folklore.) “I’m going to find someone for...
DCS Greenhouse Downed By Wind Shear In Maine
Just wanted to post an announcement that this morning we had a 55 mph wind shear that completely demolished our 45 ft. greenhouse. The winds are still pretty bad and are expected to peak around 5pm this evening. DCS will be closed today, I don’t want power...
Complaints Won’t Get You What You Want
People who have been burned by a private disability company often become so angry that the eyes of revenge turn livid and efforts are made to “make the insurance company pay”, or “get them in trouble”, and even expose them to the press....
Summer Sun And Surveillance – Summer 2021
This is just a reminder that with better weather and a loosening of lockdowns, insurance surveillance is back on the insurance agenda. If you’ve had inquiries from your insurance company about verifying your address, chances are a surveillance is being planned....
