Physicians Sitting On The Fence – No Benefit To You
In order to have a successfully paid disability claim all treating physicians must agree to support your disability by writing medical restrictions and limitations that preclude you from working. No medical support….no disability claim. Of late, I’ve...
Eliot Spitzer – A True Advocate For Insureds
I’ve been receiving questions about Eliot Spitzer lately; frankly I don’t know why, but it’s a very interesting story. Attorney Spitzer was the Attorney General in New York (1999 – 2006) who was just short of bringing criminal charges against...
Disability Claims vs. Narcissistic Personality Disorder
In the course of assisting insureds with their disability claims, I’ve discovered, sometimes unfortunately, that having disability claims in combination with narcissistic outlooks and behaviors on the part of insureds, often cause claims to be untimely, and...
Unum – You’ve Got To Be Kidding Me!
I called Unum today and its voice mail included a notice informing callers that not all COVID-19 claims will be paid. Why would Unum put a notice like that on its menu service? Obviously, the company is trying to discourage people from filing COVID-19 claims, which...
Prudential’s Future IMEs. What A Waste Of Time!
It came to my attention today that Prudential is pre-scheduling IMEs for future dates as if the company has a crystal ball and can predict an end to COVID-19 and a return to normal living. The claims handler I spoke to regurgitated the company’s line when she...
Friday Q & A On Saturday
How can I coordinate Worker’s Comp and STD? There isn’t anything to coordinate since 99% of Employer’s STD Plans won’t pay for on the job work accidents payable through Worker’s Comp. It is usually and either-or situation. For LTD,...
When You Grieve Losing Your Job Due To Disability by Linda Nee
In the last twenty years nearly every insured I’ve ever spoken to, or had contact with, describes emotional troubling times when a physical or mental disability prevents them from returning to their occupations, careers or businesses. Not only are there...
Unfortunately, That Ship Has Sailed…
Lately, I’ve been contacted by several claimants with recently denied claims asking for my help. I know I’ve written about this before, mainly to encourage claimants and insureds to contact me BEFORE claims are denied and not AFTER. Most of my readers may...
IDI Injury vs. Sickness Provision Abuse By Insurers AND Insureds
OK, I’ll say it! All IDI insurers abuse Injury (Accident) vs. Sickness provisions in IDI policies. Nearly all IDI policies distinguish between Injury and Sickness usually by paying sickness to age 65, and injury Lifetime benefits. While most IDI insureds often...
Unum Refuses To Overturn Denial On Appeal Of IDI Residual Disability Based On Earnings – Urgent Read For IDI Insureds
As we are all aware, in the last several years Unum began reversing several of its claims management tactics for IDI claims. Probably seen as beneficial boosts to profitability, Unum’s calculations regarding “Residual Disability obviously are not now what...
Is Your Insurance Company Gaslighting You?
Apparent in our current insurance industry is a growing percentage of disability claim insureds who seem to accept, and act upon, perceptions about disability claims, after having been “gaslighted” by the very companies they depend on for financial...
I Don’t Get That Rationale At All
Last week I received several phone calls from insureds who told me basically the same thing: “I contacted several attorneys early on, but I didn’t want to pay them anything until my claim was actually denied. Now it’s denied what do I do?”...
Friday Q & A -5/15/2020
How can I coordinate Worker’s Compensation and my STD payments? There is generally nothing to coordinate. Usually, STD Plans will NOT pay claims if the claimant has or will file for Worker’s Compensation. Employers may play “Gotcha!” by...
COVID-19 Updates – 5/8/2020
Insurers Back On Deadlines In the last week or so it is evident that most insurers are back to their normal practices of harassing insureds to meet deadlines when in some states it remains impossible to do so. DCS recommends downloading treating physician’s...
Friday Q & A – 5/8/2020
There were quite a few questions submitted to DCS about HIPAA and ERISA. There are many good posts about these subjects if you Search for them from the Home Page. What are the ERISA Rules on pre-existing condition? The Employment Retirement Income Security Act of 1974...
“No More Mr. Nice Guy” – No exceptions!
While it appeared, during these last difficult months of national lock-down, that insurance companies were relaxing requirements to provide proof of claim, particularly affecting “new claims”, in reality most insurers today have reversed the Mr. Nice-guy...
Welcome To Reality – Again…
If I had just $1 for all of the articles I’ve written concerning “proof of claim”, claim decision-making, and who makes claims decisions I would indeed be a very wealthy woman by now. Although in the past I’ve hinted, danced around, and walked...
Guardianship Of Insurance Agency
Recently, the ethics of insurance “agency” came into discussion when a sales agent of Guardian suggested he intervene in the decision-making process in order to “assist” an insured he sold a policy to obtain an approval decision. While...
Disability Insurance COVID-19 Operations In A Rut
Disability insurers generally have their internal claims review processes down to a science. Not only does management have daily access to statistics, financial reserves, and unit operational numbers, CEOs and VPs can tell you minute details round the clock. You...
An Update On FMS Disability Claims
Fibromyalgia and Chronic Fatigue Claims have long been a source of denial by most American insurers. When I was a claims hander those diagnosed with FMS were treated with morphine pumps and yet today patients are expected to “get up on a treadmill” and...
