Although its unclear to me why so many insureds are reporting verbal abuse on the phone, apparently claims handlers are stressed out enough to really let “claimants have it” on many different levels. We are already aware that there is no such thing as customer service in an industry focused on hurting so many people for profit. In my opinion, however, there’s no excuse for rudeness.
I received a call from a young woman who described a conversation she had with her claims specialist at RMS. The specialist told her there was nothing wrong with her and that according to the medical review of their outsourced neurologist (a former Unum doctor), she could return to work. All this after extensive proof of claim had been submitted to Disability RMS supporting total disability.
In addition, the claims handler also refused to communicate in writing and disclose the name of his manager. After later getting through to the RMS manager, the claimant reported an identical attitude directed toward her that was “rude and hateful.”
“The conversations I’ve had with RMS made me feel as though I had done something wrong and that I was in danger of going to jail. I’m just disabled and can’t work, not a terrible criminal. Every time I speak with them I am made to feel the same way.”
Disability RMS is an insurance reinsurer staffed in part with former Unum employees. Basically, Unum’s tendency toward “bad faith” transfers to other companies such as RMS, Sun Life and The Hartford when employees from Unum find jobs elsewhere. Still, any insurance company who denies claims unfairly should at least be polite.
The growing trend toward treating private disability insureds as criminals is due in part to pressure placed on claims specialists to deny more and more claims. Despite what most people think, the job of disability claims specialist is more like a widget factory than a mid-level administrative position.
Those who have ever worked in a factory with assembly lines can appreciate the disability claims process that places claims through internal referral resources in order to “stack the deck” with documentation supporting non-payment. Claims are placed on the internal review process assembly line and are either paid or denied at the end. Managers pressure staff at risk of employment termination if they can’t deny claims at accelerated levels particularly at month, quarter or year-end.
Claims handlers are in reality little more than glorified administrative assistants who continuously push claims through a prejudicial game of “Texas Hold’em.” As I’ve described in previous posts, the real skill of claims managers is to juggle claim denials and approvals to meet financial reserve goals. Managers are also pressured by executive management to “roll in” more and more profits each year.
Unattainable profit targets create stressed out managers. By the time that same stress reaches the bottom rung of the ladder, claims handlers are ready to pop. The result is an entirely different approach to customer service, namely, there isn’t any.
To be clear, it is entirely inappropriate for claims handlers to express opinions directly to claimants as to whether they are disabled, or can return to work. It is equally egregious for claims handlers to communicate any opinion or judgement relative to the claim or intent of claimants. Claims handlers are NOT specialists in any particular area (medical, financial, occupational) and should refrain from “putting in their two cents worth” particularly to claimants directly.
It is important that claims handlers understand the administrative nature of their jobs and not try to place too much importance on their roles particularly when in most companies claims handlers do not have autonomy to make claims decisions on their own without some sort of validation from managers. It has taken me nearly a week to get payment on a claim at Guardian because it was sitting on a manager’s desk waiting to be approved and validated.
As a former Unum claims specialist I understand entirely what it is like to sign letters you don’t write, have responsibility without control, be an accomplice of secrets while at the same time on the front line with insureds. Still, inappropriate phone exchanges with the most vulnerable in our society is an outrage. No one should have to fight so hard to receive what is already due them.
For all of these reasons DCS, Inc. continues to recommend to insureds and claimants that they request all communications from insurers in writing.
Anytime, any entity, organization, person, group, or media resource causes a disabled person to feel bad, or less than they are because of a disability or claim, they are abusing their discretionary authority to make fiduciary decisions on behalf of those they sell policies to.
Insureds and claimants do not have to subject themselves to abusive verbal exchanges and should immediately request to receive all communications in writing in the future. It is not a crime to be disabled and anyone who takes advantage of that fact is nothing more than a bully.