Lincoln Financial is by far one of the most deceptive private disability insurers there is. I hear a great deal from employers who, frustrated and fed up with Lincoln’s deceptive practices, eventually move on to other Group Plan insurers.
Although most insurers today engage in the same old unfair claims practices, Lincoln seems to go out of its way to be deceptive. Seemingly kind and well-spoken managers assure claimants all is well until a denial letter arrives suddenly in the mail.
“But, that’s not what you told me!”, one claimant informed DCS, “Lincoln assured me I would be able to submit additional information, but then denied my claim. Why?”
Lincoln’s representatives and managers are not truthful. The claim was suddenly denied in order to meet profitability targets for 1st Qtr. Despite all else that was told to the claimant and her manager, (she was working part-time), Lincoln denied the claim without updating medical information. Now, the claimant is forced to retain counsel for an appeal that will further reduce her benefit and money she has to live on.
I wonder sometimes whether my readers take me seriously when I caution them that insurers deny claims in a timely fashion for profitability. If insurers can reduce financial reserves, reserve “gains” are realized and there is an immediate contribution to profit. Placing claims on Reservation of Rights status is the same as engaging in “off-Balance Sheet financing” by significantly reducing future liability for claims.
In my opinion, most private insurers are significantly “under-reserved” meaning there’s not enough actual cash placed in “reserve” to pay future claims. I think if regulators took a closer look at companies such as Lincoln, and Unum in particular, they would find that these companies are under-reserved and lack cash resources to pay future claims.
Nevertheless, it is unfair and deceptive for Lincoln to inform claimants they can submit additional information and then before they can do that, deny claims. Lincoln Financial also has a deceptive appeal review procedure that denies claimants the full 180 days allowed for ERISA appeals.
Further, I doubt very seriously Lincoln actually puts any weight at all on medical documentation sent in on appeal. In most cases, Lincoln only takes about a week or two to review the information and then affirms that the previous denial decision was correct. The company also refuses to review any additional information sent in within any remaining days left on the 180-day ERISA timeline stating, “you’ve exhausted your Administrative appeal.”
In my opinion, no employer should buy Lincoln’s group Plans without a specified service agreement. I think that employers may not know that they can ask for “service agreements” demanding certain levels of customer service and payment of claims. If Lincoln doesn’t measure up, annual premium paid by employers can be reduced.
Currently, employers are running to the hills when they discover Lincoln’s deceptive manner of doing business. In any event, those who have claims with Lincoln should make every attempt to “see and listen through” the company’s baloney.
Lincoln doesn’t deal honestly particularly when a profitability period is right around the corner. This kind of deception is an unfair claims practice.