Neurology, Unum Group, And Migraine Claims
Lately, the scuttlebutt among legal and consulting circles is that Unum is out of control – again. Personally, I don’t think it’s just Unum, I am of the opinion that all insurers have left the realm of file review sanity. Still, reports of Unum...
Reliance Standard’s Falsehood Agenda
Like most business dealings there are rules which dictate “fair and honest dealings between parties. Although some might think the disability insurance industry doesn’t have any rules, that’s simply not true. ERISA reviews are held to standards of...
Living With A Disability Claim – “I Just Can’t Do This Anymore!”
There is a growing number of insureds and claimants who recently shared with me their frustrations with the disability claims review process after a period of time and working through the system. The requirement of having to submit frequent medical updates, fill out...
Pain – An Ongoing Problem That Hurts
Pain. Although most of us endure the occasional aches and pains of tension headaches, bumps, thumps, bruises, strains and sprains, there are many others who suffer daily chronic pain, which cannot be lessened with over-the-counter remedies such as Tylenol or Advil....
SSDI And Private Disability Insurance Two Different Things
It never ceases to amaze me what insurance companies can come up with to coerce claimants to give up their SSDI files. And, unfortunately, claimants believe what they are told, and do as they are commanded, sometimes to their own demise. First of all, let me say that...
End of 3rd Qtr. Profitability – 30 September
Most of my readers here know that I usually remind everyone of insurance “profitability” time periods to be aware of, but some may not realize why I do that, or what it means. September 30 is the end of the third Quarter, and insurers have been targeting...
Mental Illness And Disability Claims
Although most Plans and policies do cover depression and anxiety and mental illness, over time, insurers have developed strategies perceived as prejudicial and biased in order to deny claims after only 24 months of benefits. To ensure deniability, insurers further...
Independent Medical Evaluations
Now that all insurers are engaging in questionable claims practices, it’s time to remind readers of “best practices” for Independent Medical Evaluations. IMEs are perhaps the number one source of profit risk management. Therefore, it’s time to...
Reliance Standard’s Egregious Claims Practices
Apparently, Reliance Standard is targeting claims with associated mental health issues in order to deny them after 24 months of benefits. This is not the first time insurance companies have tried this particular unfair claims practice, as evidenced by the Multi-State...
“Indexing” May Save Your ERISA Claim
“Indexing” in ERISA Plans has always been a source of confusion especially when it is confused with Cost of Living Allowance (COLA) provisions. In fact, “indexing” is only used on two occasions in Group ERISA Plans. 1) “Indexing”...
Neck ,Back, Chronic Pain and Migraine Disabilities
While cardiovascular disease remains the number one claimed disability in America, neck and back claims come in a close second. Number three is migraine headache. Although one might think a “back or neck” claim would be easy to support because of the...
The Most Egregious SSDI Scam Used By Insurers
Most claimants are totally unaware their ERISA Plans enter them into a stacked-deck game of Texas Hold’em they eventually cannot not win. Claimants believe their STD/LTD Plans are benefits paid for by employers that make up a sizable portion of their well-earned...
Insurance Companies Are Targeting Neurological Disorders
It has come to my attention that insurers are targeting neurological disorders because this category of disability is often “subjective”, meaning there are few tests to prove patients have what they say they have. Although there are more than 600...
You Can’t Nail Jello To The Wall
I’m not quite sure why insureds continue to defend their claims with inadequate proof of claim, or medical information that does not specifically cite restrictions and limitations. I realize that I may not reach all insureds with my articles, but I must have...
The Truth About Insurance Surveillance
I just finished updating one of my articles called, “The Truth About Insurance Surveillance.” I am happy to send my 13 page document to readers with a donation of any amount from my website: http://www.disabilityclaimssolutions.com Clients may...
Make Sure You’re Right Before You Complain Or File An Appeal
There seems to be quite a few insureds out there who are managing their own claims. As soon as I write an article remotely suggesting that’s not such a great idea, someone will email me a note saying, “But, I managed my own appeal and I won!” Or,...
Medical Wrong-Thinking About Your Claim
I know I must be sounding like a “broken record” when it comes to articles about providing good, solid, medical proof of claim. But, I’m seeing, and hearing about more and more denials from insurance companies citing lack of medical information, or,...
Attention Unum Insureds And Claimants – This Is Pretty Serious
Most of you probably weren’t in the disability environment when Unum was found to be engaging in claims practices that were unfair. (2004) One of the concerns of the Multi-State Regulators was that Unum was depending solely on internal medical reviews and were...
When Your Doctor Won’t Certify Disability
There seems to be an outbreak of treating physicians who refuse to write medical restrictions and limitations, or are reluctant to say someone is “permanently disabled.” My impression is that physicians have become reluctant to be involved in disability...
Ignoring Good Advice May Be Costly
I have to admit I have no idea why some people retain my services and then ignore what I tell them. It’s just something that seems inherent to my profession, and although I feel sorry for the eventual denials that come back to me, there is nothing I can do if...
