“Better Than Sliced Bread” IDI Policies Are Toast
As most physicians, dentists and highly paid executives know, policies were sold in the 1980’s and 90’s as “own occupation better than sliced bread” coverage. At the time, it was believed by insurers that highly skilled professionals would...
Unum Insurance Defense Physicians And Doc-To-Doc Calls
Many of my readers may recall previous articles concerning Unum’s paid physician reviews and what are called, “doc-to-doc” calls. Unum’s agenda for the calls is to persuade treating physicians its medical review is the only accurate one, and...
Unum Updates – What Next?
The “hungry vulture’ strikes again with continous requests for more and more SSDI information to re-calculate SSDI awards looking for every nickel and dime it can find. Some claimants are asked to submit SSA paperwork over and over again allowing Unum to...
Signs Of Bad Faith Investigation – A Reminder
An insurer may be acting in bad faith if the insurer delays or denies investigation or payment without a reasonable basis for its delay or denial. ERISA claimants must be notified in writing at 45-day intervals (tolling letters) as to why the liability decision has...
Daily Buzz – Monday, February 17, 2020
Just say, “No”. Recent information has it that Unum may be asking insureds to allow the company to speak with spouses and children. While I would think such a request is an obvious “stick it in your ear” kind of question, callers to DCS are...
Friday Q & A On Thursday
Does Prudential try to deny claims? Prudential is at least in the top five ERISA group employers who actively seek to deny claims. In fact, Prudential is well-known in the industry for its unfair and discriminative denials of mental health claims. Patient notes are...
Surveillance Video – “Seeing Is Believing”
Most of my readers know that I often write about the necessity of abiding by medical restrictions and limitations so as not to provide insurers with “inconsistency of report” that often leads to denied claims. A case was brought to my attention: Farron...
Living With A Disability Claim – Kindness Counts!
Today, it almost seems as though we live in a convoluted world where everything said and done seems to be offensive to someone. This is especially true for those who live in a world made up of fear, pain, and depression resulting from disability. What I’ve...
Under The Magnifying Glass – Editorial By Linda Nee
It has never occurred to me that insureds, especially those who are considering retaining my services, conduct investigations of me, suspiciously trying to challenge my credibility. Not once in the last 20 years have I ever pulled a credit rating or checked out any...
Physicians Who Walk Around You To Insurers
Most treating physicians really care about you and your disability. They and their staffs spend extra unbilled time to meet the requests of insurance companies, and generally assist insureds in every way they can. However, treating with physicians who have your best...
Unum’s Deceptions – The Truth Is The Truth Regardless
Although it’s quite common for insurance companies to misrepresent Plan and policy provisions, it’s becoming more common for claims handlers to cite provisions from Plans and policies saying one thing, and then alleging it means another. I find this...
Unum Rep Resorts To Fear Mongering To Obtain SSDI File
Recently, I spoke with an individual who received a letter from Unum that really was “the ghost from hell” letter. The letter itself was 8 pages in length consisting of one regurgitation of policy provisions after another. The issue was that the claimant...
Complacency Does Not Equal Claim Success!
The definition of “complacency” taken from the Webster Dictionary is: ‘self-satisfaction especially when accompanied by unawareness of actual dangers or deficiencies.’ “If I don’t challenge my insurance company or make waves,...
The Standard’s Questionnaires – A Cautionary Tale
I had an opportunity to review one of The Standard’s questionnaires, and like many other insurers’ forms, exceeds the limits of insurance investigation in a deceptive way. As always the wolf is hiding in sheep’s clothing in order to mislead insureds...
Treating Physicians Demanding Functional Capacities Evaluations
Part of the “new normal” for 2020, already evidenced by several claims I’ve reviewed, is the recent tendency of treating physicians refusing to complete “Functional Capacity” sections on update forms without the result of formal FCEs....
Surveillance Under Way – Be Sensible And Watchful
Several insureds have recently reported to me that they either are, or have been, investigated by insurance surveillance agents. In one instance, surveillance investigators went right up the insured’s door, knocked and demanded to be let in. This situation put...
“I’ll Take A Lawn Chair And A Beachball”
Here is another article I wrote about Unum’s history of paying claims. Unum’s history is a matter of public record now, and is nothing to be particularly proud of. All corporations provide employees with some type of incentives whether in the form of...
Insurance Companies Do Not Advocate For You
One of the issues I was made aware of in 2019 and more recently is the ongoing trend of claimants and insureds to consult claims handlers for advice on how to manage their claims. “I need to stop working” four months from now, can you explain to me what...
Unum’s Release Point – Out Of Plan One Week Timelines?
Two of the most important ERISA Group Plan provisions require claimants to submit medical and all requested information “at their own expense” and “within 30-45 days of it being requested.” This is very much a standard provision in all group...
DCS Clients – Please Read My Emails!
Just a reminder that I sent out a DCS, Inc. client email that is very important for 2020. Please open and read all of my emails, but this one in particular is very important for you to know. If you are a client and did not receive my most recent email, please let me...
