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Reminders

THE NEED TO BLABBER………

Nearly every caller to DCS in the last month describes “horrible” claims experiences “when speaking to insurers on the phone.” Of course, as most of my readers know, DCS, Inc. supports the rights of insureds to request all communications in writing so that he/she will actually have time to think about what appropriate responses should be. Insureds taking certain prescribed medications should also be aware that written communications are in their best interest.

When given the opportunity, most insureds, by human nature, feel the need to try to convince insurers claims are credible. As a result insureds OVER SPEAK claims feeding insurers with information that really isn’t relevant to claims decisions. In addition, some insureds can only calm their stress and worry by picking up the phone to gain reassurance from claims handlers that all is well. Speaking to insurance companies on the phone is generally a recipe for disaster whether the conversation is  between claimant and insurer, or claimant’s physician and insurance doc.

To be clear, insureds and claimants need to provide honest and truthful answers to financial, occupational, and medical questions raised by insurers. As long as the information is provided in writing, and insureds are forthcoming with relevant information, there is no negative context or consequence to requesting all communications in writing. It’s generally NOT the insurance company that has a problem with written communications, but insureds who just can’t keep their hands away from the phone, or who continuously need to be reassured all is well with their claim.

Insureds should also be reminded that it is impossible for anyone to convince their insurance company of the credibility of a disability claim. Insurers do not care what YOU have to say, but rely on their own assessment of internal review to make determinations to pay or not pay claims. Most of, “I wish I could return to work, but I just can’t” goes in one ear and out the other and probably isn’t even written down in the record.

The only time insureds should communicate with insurers by phone is to inquire, “When can I expect to receive my check?” Disability checks can be late , and literally the only way to resolve anxiety is to call and find out when you can expect to receive it. Other than this one situation, all communications with insurance companies should be in writing.

For claimants who are still trying to manage claims themselves, all communications between insureds and insurer should be in writing. If disability insurance were any other business transaction you would insist on having written communications. DCS, Inc. continues to support the rights of insureds and claimants to request all insurance communications in writing.

Creating a paper trail with accurate information that cannot be misrepresented is a best practice in disability claims management.

STAY AWAY FROM INSURER EMAIL WEBSITES…..DON’T ENCRYPT…FAX.

Insureds and claimants are reporting major confusion and delays when communicating with insurers via designated websites. Paperwork is continuously lost; and, communicating with insurers by email probably causes more of a danger of OVER SPEAKING claims than phone calls. As most of you know, email isn’t the best means of communication, and insureds may have a tendency to write more in emails than they ordinarily would say.

DCS, Inc. opts for the more conventional paper trail of faxing well-written, clear letters to insurers. Information should be sent US Priority Mail with Signature Confirmation. Priority Mail can be tracked and it’s very hard to dispute lack of receipt when signature confirmed.

Encrypted email websites also do not insure communications from the sites are added to Administrative Records and claim files. Attorneys should take particular notice whether disclosed claims files contain downloads of encrypted website communications and paperwork creating a complete disclosure of the official record.

In any event, insureds and claimants should stay clear of insurance email websites and opt for faxed written communications and Priority Mail.

As a reminder, communications should also not be taking place between patient and doctor by email.

This just in…..

Apparently, Unum’s website places a tracking cookie on your system. Think about this very carefully.

Got EthicsYesterday an insured asked me if disability insurers had any common standards of ethics they abided by in the conduct of business.  As most of you may or may not know, a good definition of “ethics” in business is a system or code of principles that guides and directs our actions toward others.

In nearly every religion in the world, “the Golden Rule” is the guiding norm of “treating others as we would like to be treated.”

In Judaism: “Thou shalt regard they neighbor as thyself.”

In Islam: ” No one of you in a believer until he loves for his brother what he loves for himself.”

In Christianity: Do unto others as you would have them do unto you.”

In Buddhism: “Hurt not others with that which pains yourself.”

In Hinduism: “Good people proceed while considering that what is best for others is best for themselves.”

In Confucianism: “What you do not want done to yourself, do not do to others.”

If you were the only person in society, there would be no need for ethics since you would be the beneficiary of all goods and services. However, since we do not exist alone, limited goods and wealth must be distributed and that means we will all eventually disagree. Although there are two methods of dispute resolution: the use of force, and the use of reason, disability claims dispute resolutions evolved over time as corporate abuse of money, power and conflict of interest against those who are the weakest and most vulnerable in our country.

To be completely unaware of the ethical issues that have plagued disability insurance for decades we would have had to be living under rocks of ignorance devoid of newspapers, television, cable and social networking.  Multi-million dollar bad faith lawsuits, multi-state conduct market examinations, and precedent-setting court cases have failed miserably to improve the public’s perception of how insurers conduct their business. Still, disability insurance is a billion dollar a year industry that continues to sell disability policy coverage insurers have no intention of paying.

According to a recent public survey of the ACLI entitled Monitoring Attitudes of the Public, the following responses were common:

  • 36% of people have negative opinions of the insurance business;
  • Fewer than one-third felt the industry was either fair, trustworthy or caring;
  • More than 50% felt that policies are difficult to understand and that agents try to sell them insurance they know little about or don’t need;
  • 45% felt that account agents don’t tell the whole truth when selling insurance;
  • Over 60% of people believe the insurance industry engages in unfair claims practices.

Clearly, the public’s perception of insurance in negative although millions of policies continue to be sold.

Disability contracts are referred to as  “contracts of adhesion” meaning that one of the parties to the contract has no say regarding the terms. In theory although great discretion should be given to the party with no bargaining power our system of legal justice and political appointment of judges (particularly Republican), leaves principles of adhesion, discretion, estoppel, and conflict of interest by the way side.

“Adhesion” is actually the guiding principle behind insurance “discretionary authority” giving insurers the sole right to decide who to pay and not pay, or what the policy means. Marketing insurance products where one party has total “discretionary authority” and the other “no rights at all”, leaves little room for disagreement that can be resolved by ethics.

Since disability policies ARE contracts of adhesion, both the employer and/or Plan Administrator/Insurer are co-fiduciaries to the policy and have certain duties and responsibilities:

  • The duty to conduct review investigations in “good faith and fair dealing.”
  • The duty to provide for a claims review process that is fair, equitable and conducted with reasonable care.
  • Duty to fully disclose all pertinent information (ERISA) to the claimant;
  • Duty to avoid conflicts of interest;
  • Duty to be diligent;
  • Duty to act in good faith and with due diligence;
  • Duty to decide all indeterminable issues in the favor of the claimant or insured.

Unfortunately, “duty to avoid conflict of interest” and “discretionary authority” are opposites leaving insurers free to exercise their discretionary authority filling coffers with billions in yearly profit. Insurance in America has lost its ability to self-impose  standards of “good faith and fair dealing” at the expense of those who depend on the industry to pay up. Where are the ethics you may ask? Clearly, there are none.

When considering questions such as : “How can Unum do that?”, or “How do claims handlers sleep at night?”, it might be helpful to answer, “Because they can.”

Disability contracts are enforceable legal documents of adhesion leaving insureds and claimants with no power or say over the process of review or ultimate decisions made.

In my opinion the “Golden Rule” does not in the end triumph over the insurance robber barons who are successful in selling products for which there is no moral or ethical code of conduct. Essentially, Americans are NOT treated by corporations as they themselves should be treated.

Perhaps it wasn’t a good idea after all to regard corporations as “persons” under the eyes of the law. It’s pretty hard to get an ethical fair shake from a sterile, impersonalized robot.

PA1959Although emphasis is usually placed on the role of claims handlers, it is actually the claims manager/director/supervisor who makes decisions as to whether claims should be paid or not. In reality, claims handlers are little more than glorified administrative assistants pushing claims through a hierarchical maze of review, added documentation, and collection of required data.

Claims managers,  on the other hand, are the true decision-makers who”validate” or “approve/deny” claims by manipulating financial reserves to achieve any desired profitability target given to them by executive management.

To begin, claims managers may have as many as 10 direct reports (claims handlers) each assigned a “block of claims” from 80 to 200 insureds or claimants. After an annual “offsite” of executive management, each manager is allocated a specific financial reserve target (profit) he/she is expected to “roll in” each month, quarter, or year-end. In order for the company as a whole to achieve corporate profitability, managers must achieve their specific target numbers. This is why managers participate in many corporate financial incentive programs because without their skills in manipulating financial reserves corporate showing of profitability could be in jeopardy.

THE PLAYBOOK

A claim financial reserve is money “put away” to cover the liability of claims in the future and is shown as a corporate liability on the Balance Sheet. A reserve loss is an increase in liabilities (loss) and a reserve gain in a decrease in liabilities and immediate contribution to profit. Each claim has a financial reserve whether the insurer admits to it to the public or not. Claims denied or terminated are immediate contributions to profit. A file reserve is opened when an initial application for benefits is received and the financial reserve is eliminated when claims are denied eliminating the liability and creating profit.

Good claims managers can manipulate the timing of financial reserves in order to maximize profit gains. For example, if a claim is both opened and terminated in the same month, it is a wash. If the claims manager delays the denial until after the first of the next month, a reserve gain is created. Have you ever questioned a claims handler about a claims decision only to have one delay after another? New claims decisions are more likely to be communicated after  the first of the month so that a financial reserve gain can be recorded.

In addition, managers can “hold up” the process of approving/denying claims by juggling claims approved vs. those denied. Consider. If your claims handlers are collectively recommending more approvals than denials progress toward profitability targets will not be made. The reverse is preferable. For example, if a DI claims handler recommends an approval of a claim with a financial reserve of 1.5M (ouch), the claims manager may want to hold up “validating” the approval until there are enough “denied and terminated claims” to offset the loss of paying such a high reserve claim. It may be that the manager would want to “hold up” on the approval of the wealthy DI claim until there are approximately 6 ERISA claims to deny in excess of 1.5M in reserve.

Another alternative the manager has is to pay the DI claim under Reservation of Rights (a pay status that does not recognize the full financial reserve) when there are scarce ERISA claims to deny to offset the reserve. Insureds and claimants may wonder why they get the runaround from claims handlers regarding timely claim decisions. Claims handlers can’t communicate claim decisions until their managers “validate” or approve them based on reserve manipulations. This often places claims handlers in very difficult positions – they communicate with insureds, but can’t really divulge claims decisions even when they may in fact know the outcome.

Most insureds and claimants believe “claim review investigation” is a matter of obtaining patient notes and medical information when in fact it is part of an intricately planned manipulation of financial reserves and timing. Managers who can’t juggle the timing of claims decisions are immediately fired, that’s how important this is. When the pressure is put on claim mangers it is, of course, floated down to claims handlers for faster and quicker completion of claim documentation.

It is important for anyone with a disability claim to understand there is more at stake here than just “here are my medical records, pay me.”

Years ago Unum managers had a system called OMAR that listed all claim financial reserves from highest to lowest. Recent Unum terminated employees tell us managers still have access to claim financial reserve data. Other insurers have similar systems in place to manage claims decisions. Recently, Unum mis-communicated a present value calculation to an insured because he had more than one Unum policy and the company under reserved the liabilities. Occasionally, insurers are caught red-handed by state authorities or the SEC because their reserves are too low and companies engage in “off-balance sheet financing.”

One might in fact conclude that the most important aspect of disability claims management is NOT medical or vocational review, but manipulating financial reserves to show profit rather than losses. The more claims are paid, the more losses are incurred. Contributions to corporate profit always represent the excess of financial reserve of claims denied over those paid. Insurance actuarial information can be very complex, and yes, insurance companies have several financial reserve figures depending on whether interest is included along with many other factors.

Disability claims management is not about material and substantial duties, or vocational assistance, or even doing the right thing. Claims management is primarily a deliberate system of decision manipulation for the purpose of showing profits, not losses. Who knows what the true financial position of any disability insurer really is when the name of the game is juggling financial reserves for profit?

Two of the most important Generally Accepted Accounting Principles (GAAP) relates to the Time Period and Matching Principles which state that time periods can be created but that expenses must be matched in the same time period as revenue. Who really knows what the financial condition of any disability insurer is when financial reserves are manipulated in order to create financial statements that are essentially Aesop’s Fables?

In any event, claims managers, and their ability to juggle and manipulate claims decisions (financial reserves) is an essential part of the claims process and that’s why they get paid the big bucks.

 

Friday Q & A

Q&A1Can an insurance company demand repayment of a overpayment after 3 years?

Yes. In fact, most policies now contain provisions that clearly state errors can be corrected and collected at any time.  Remember, whatever disability insurers pay, they can also take back. Claimants do not need to necessarily agree that the overpayment is owed either. Insurers typically reduce benefits to $0 until the overpayment is recovered.

Linda you frequently use the term “stacking the deck”. What exactly do you mean?

There are quite a few posts on Lindanee’s Blog dealing with “stacking the deck.” Basically, “stacking the deck” describes the process whereby disability insurers “float” claims from one internal or external resource for the purpose of obtaining what appears to be credible evidence supporting business decisions not to pay claims. Insurer goals are to create the illusion of credibility by generating more and more paperwork lending to the opinion that decisions to terminate claims are the only correct decisions to make. If enough paperwork can be generated documenting the same thing, it looks as though there is a consensus the claim should not be paid. This is why it is very important for insureds and claimants to do the same thing by making sure insurers never have a consensus in the file about anything.

My Unum check is late. What do I do?

This is the one and only occasion when DCS recommends picking up the phone and asking, “When can I expect to receive my check?” Claimants should NOT ask, “Why is my check late?” because the “why” doesn’t matter. What you really want to know is WHEN you can expect to receive it.

Unum is the only insurer I know of that has a problem getting checks out on time. For most, it is because  Unum claims handlers take off on PTO and “forget” to approve benefits due while they are away. Unum checks have a tendency to be late after holidays by as much as a week. In order to relieve the anxiety and stress that comes with late checks, claimants are much better off calling Unum to find out when they can expect to receive their checks. Be aware though that some claims handlers may take the opportunity to engage claimants in conversations about other things. Therefore, claimants can say, “Please overnight my check to  me. If you have any other questions about my claim, please send them to me in writing and I’ll respond promptly.”

Clearly, Unum has an administrative glitch in their benefit payment system that creates havoc with getting checks out on time. If other insurers can provide timely benefits, why can’t Unum?

What physicians generally refuse to support disability by filling out forms?

Osteopathic surgeons and pain management physicians typically refuse to complete disability paperwork after a time. Osteopathic surgeons primarily engage in pre-op, surgery, and post-op care. Beyond that, most osteopathic surgeons defer long-term disability opinions to family physicians who are most likely Internists. Insureds who choose not to agree to future surgeries may find themselves left without a physician. For osteopathic surgeons the money is in surgery not time spent filling out disability paperwork for years. It’s always best for surgical patients to maintain relationships with family physicians who are more inclined to support disability by filling out paperwork.

Pain management physicians also often refuse to support disability with the rationale that they are not diagnostician, but only treat symptoms. In my practice I’ve had great pain management docs who go the extra mile to continue to support insureds as well as doctors who refuse all together. Once again insureds should maintain relationships with other physicians in addition to pain management MDs who tend to refuse to fill out forms.

 

Daily Buzz

RemindersArbitrary Deadlines

Ever wonder where your insurer gets those “out of the air” deadlines they cite in letters requesting information? For ERISA claims the deadline could contractually be 30-45 days, but then again it could be as little as a week or two. Insureds should be aware that insurance deadlines for information often coincide with end-of-the-month profitability reporting.

For example, Unum’s letters are now requesting information no later than July 28th “or we will make a decision based on information in the file.” This statement isn’t a very “claim safe communication” to insureds. What it’s really saying is that Unum already prepared the file for termination as of July 31st and you have “one shot” to send additional information.

Disability insurers do not do anything unless it is related to a future profitability reporting period such month-end, quarter-end, or year-end. Claims are positioned as either payable or non-compensable as of a particular period of time. Management planning includes manipulating claims-paid, and claims-not-paid so that targets of financial reserve gains can show profit when it’s needed for financial statements and stockholder dividend declarations. Juggling claims to determine who gets paid and who doesn’t depends a great deal on financial reserve gains and losses.

The due date in your letter isn’t just a date, but an “expected recovery of a financial reserve” or profit.

Confusing DI Policy Amendments

Recently, there’s been some confusion among DI policy holders regarding when certain amendments take effect. For example, Mr. B. went out on disability and began receiving benefits from Unum in 1997. In September 2000 his policy was amended allowing a 2% increase COLA option. From 1997 to present, Mr. B. went off and back on claim several times since he returned to work but couldn’t remain there. Every time he went back out on claim, Unum paid him benefits back to his previous period of disability. Therefore, there was no non-payment period even though it looked as though Mr. B. went in and out of disability several times.

Mr. B. contends that since he applied for the 2% COLA increase during a period when he was not technically receiving benefits, that Unum should pay him the COLA increase retroactively to September 2000. This is incorrect.

Policy amendments that go into effect AFTER a date of disability are not payable for that particular claim. Since Mr. B. went out on disability in 1997 and the amendment didn’t go into effect until September 2000, the 2% COLA increase does not apply to his current claim. In addition, although he was technically not working when he filed for the increase, Unum paid him retroactively every time we went out and back on claim.

The only time. Mr. B. would have been able to exercise the 2% COLA increase option was if he actually filed an entirely new claim after September 2000 wherein Unum make him satisfy a new elimination period. If this happened, Unum would have to pay him the 2% increase. However, since Unum paid him retroactive benefits and he never had a non-payment period, it doesn’t appear he met another Elimination Period.

Some policies do allow insureds to file for future increase options and other increases on disability, but the effective dates of the amendments must be before dates of disability. Although these issues can really be confusing sometimes, DI insureds need to know when exercise options and amendments take effect and whether they would be payable for a current claim.

“Sweetie Pie Claims Handlers”

Insurance claims handlers are well-aware they have a better chance of getting information from insureds and claimants with a “sweetie pie” communication style. Several insureds and callers have communicated to me this week that their claims hander’s voice and attitude was so “sweet” and cooperative it was obvious it was a ploy. One caller said, “The claims handler’s voice was so sickening, it was obvious she was putting me on. I didn’t trust her for a minute!”

I often wonder how stupid claims handlers think insureds really are. If you have a claims handler who lays it on pretty thick, take what is said with a grain of salt. By the way, DCS, Inc. doesn’t recommend speaking with insurance companies on the phone, in part for this very reason.

Unum’s Ridiculous and Insane Procedures

DCS, Inc. is currently dealing with a Unum claims handler whose cheese obviously slid off her cracker. She requested patient notes from a particular medical facility and those notes were obtained by the patient/claimant and forwarded to her. For the last several months Unum’s rep continues to threaten termination of benefits because our client made an error on the facility authorization and she couldn’t get the records herself. But, she has the records! It’s my guess she’s already had the patient records provided to her medically reviewed, but she continues to insist that she needs to obtain the records herself. BUT, she has the records! How can Unum terminate benefits for failure to provide when records have been provided?

What this situation boils down to is that Unum’s rep continues to threaten to deny benefits because she wasn’t able to obtain patient notes she’s already been provided with. Is it just me, or this insane?

Unum is also the company that while I was an employee forced me to obtain a medical review on a claimant who died. The company wanted to make sure the claimant was totally disabled. It makes you wonder doesn’t it?

SettlementMost individuals who sign on the settlement dotted line are perfectly content and happy with their decisions to rid themselves of insurance harassment and abuse. However, there are some, who after making a decision to accept lump sum payments as full settlement of claim, go through a period of mourning when monthly benefits no longer arrive. Although this doesn’t happen in every case, it happens often enough for me to write about it.

Perhaps without realizing it, some insureds live through a build-up of stressful anticipation and fear just before monthly checks arrive, followed by relief and a sense of protective paternalism when the money actually arrives in the mail. Insureds live through the nail-biting worry of “I hope I get my check this month”, followed by, “thank God, it’s here.”, month after month and year after year. Over time Insurance companies become very much like parents, who pay their kids an allowance every  month. Worry followed by overwhelming relief becomes an emotional habit that’s hard to break.

Second, as long as tangible cash benefits still arrive, there are those who associate the money with the career or job they once had. In a strange way, insureds my not fully accept the loss of a career or occupation as long the money is regarded as a substitute for personal identity and self-worth.  As many of you know, our culture and work ethic encourage us to believe in the looking-glass self that defines us by what we do for a living. When asked the question, “Who are you?”, most Americans will respond, “I’m a secretary”, “doctor”, or “fireman.” We define ourselves in terms of how we make money – that’s the American way.

Post Settlement Syndrome is a process of “mourning” the loss of receiving a monthly benefit even when intellectually insureds know it was the right decision for them to make. Characteristics described above, such as the habit of overwhelming stress, followed by relief/security, and the identification of benefits with self-worth, can push insureds into “regret mode” wherein for a period of time insureds tell me they wonder whether a settlement was the right thing to do.

Insureds describe reactions of continual crying, not being able to eat or sleep, and constant worry when there are no monthly benefits to look forward to. “Perhaps I did the wrong thing…..What about the economy? Did I get enough money to live on? I’m panicking because I know there’s no monthly benefit anymore. What do I do?”

Allow me to further explain that DCS Inc. takes the position that decisions to settle disability claims are individual life decisions and neither a consultant nor an attorney should advise anyone to take or not take a settlement. The role of settlement counseling is to provide knowledge concerning calculations, present value, discount rates, process and value, so that insureds can have information necessary to make good decisions on their own. Once the decision is made to sign a settlement release and accept a payable lump sum the relationship between insurer and insured is forever severed.

Post Settlement Syndrome seems to involve a sudden realization that former jobs, careers AND monthly benefits are gone, and for a period of time there is no focus whatsoever on the lump-sum sitting in the bank. Old habits are hard to break, and although there is no monthly benefit check’s arrival to worry about anymore, insureds who have signed on the dotted line substitute “settlement stress” for “benefit stress” and the cycle repeats itself for a period of time.

In addition, once monthly benefits checks cease to arrive, there is total realization of loss of career followed by confusion. If we, as Americans, identify ourselves by what we do for a living, and the monthly disability benefit goes away,  there can be a period of re-examination and definition of self and what’s in store for the future.

Mourning a settlement decision is actually the pathway to ultimately achieving financial freedom and a desire to have the quality of life that, at least in part, caused you to settle the claim in the first place. Knowing why you’re feeling so awful and regretful after accepting an insurance settlement is a first step to moving forward. There are some insureds who are so physically and emotionally affected by Post Settlement Syndrome that they actually call the insurance company and give back the money. While we don’t recommend doing this, we certainly understand it. (If you had an attorney negotiate the settlement for you, there really is no turning back!)

Disability claims are not all business and financial reserves; there is a very personal and human side to managing through the disability claims process including emotions, stress and worry after the settlement process.

Here are a few helpful suggestions that may help with Post Settlement Syndrome:

  • If you receive a lump-sum settlement offer, think it through. Read the letter carefully and determine if it makes sense.
  • Draw a line in the middle of a sheet of paper. On the right side write in all of your living expenses including prescriptions, rent/mortgage payments, doctor’s bills etc., and on the left side all sources of income if you were to take the settlement. If you have a spouse who is still working, include his/her income along with any other sources of income from rents, interest or dividend income. Determine if there is a surplus or deficit.
  • Explore investment opportunities with either a financial advisor or CPA before accepting the settlement. How will you invest the settlement money to provide interest or dividend income in the future?
  • Talk to your CPA about any tax consequences. This is a real cost and reduces the amount of actual cash available in the future.
  • Discuss the option of settlement with your spouse or partner and agree on any changes in lifestyle, or downsizing that may be necessary. The important thing is to make decisions everyone in the household can agree to and live with.
  • Think about any emotional conflicts or ongoing issues with your insurer that may be pushing you to accept a settlement when financially it may not be the right thing to do. Have clear expectations as to why you are moving in the direction of settlement.
  • Ask yourself if you have the skills and personality to manage money well. Lump-sum settlement won’t do you much good if you spend it all in 6 months.
  • Make settlement decisions based on the probability of future financial security balanced with any emotional goals to be free from insurance scrutiny.
  • If you do not understand any aspect of the settlement offer, obtain help and assistance from those who know.
  • Decide for yourself and your family whether a decision to accept a lump-sum settlement offer is right for you.

There is life after an insurance settlement, but sometimes you have to do the work to feel comfortable with your decisions.

Knowing why you’re feeling so depressed after an insurance settlement is the first step toward achieving your own family goals for the future. The good thing is that Post Settlement Syndrome does end and most people do not regret their decisions to settle.

Carrot & Stick Awards

Carrot and StickNot surprisingly, DCS, Inc. awards Mass Mutual a carrot for finally paying client benefits due for the last 8 months. With the assistance of DCS, Mass Mutual was finally persuaded its delay in investigating our client’s claim wasn’t reasonable. However, it was through this process that we discovered Mass Mutual could be following in CIGNA’s footsteps by insisting on speaking with treating physicians before paying claims. “Since when has it been a Mass Mutual internal protocol to call all treating physicians?”, we asked. The response to us was that “each claim is reviewed according to its own merits.” Good response, but Mass Mutual’s delay in paying our client wasn’t reasonable. Finally, after contacting the company on a daily basis, our client received all back benefits due.

A stick is given to Unum’s CEO Tom Watjen who appeared on CNBC and described Unum as helping employees because federal programs are insufficient. It has never been our experience that Unum helps anyone. Perhaps CEO Watjen needs to come out of the rock he’s been managing from and take a closer look at his claims and medical departments that deny claims unfairly for profit. Unum continues to be in violation of the multi-state settlement and remains an “unlawful organization.”

Although Unum’s stock price appears to be increasing, buying back 500 million in Treasury Stock artificially raised the market price. Any incremental increase in stock may not have been attributable to real growth particularly when Unum UK lost money. In fact, the Brits are still looking to rid their welfare system of Unum’s influence and in 2013 took to the streets in social protest. In my opinion “Mad Money” didn’t do their investigative homework before asking CEO Watjen to appear on the show.

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