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Dixie cupUnum Group has been in business long enough to develop internal strategies designed to encourage customer frustration, anger, complexity and ultimate despair among the American middle class. In my opinion Unum’s management considers paying claims a “profitability crime” and those who file claims, criminals.

The company’s core product, namely employer group STD/LTD, is purchased by American and UK employers as part of good faith employee benefit packages that immediately turn sour once claims are filed. Good insurance companies pay claimants what is promised rather than stabbing customers in the back when they file claims. Unfortunately, Unum’s mantra has always been to deny legitimate claims at the expense of those who mistakenly look toward its products as financial security.

From the tone of Unum’s letters to the “slinky” attitudes of its representatives, Unum Group remains the most egregious disability insurance company in the world. It’s reputation as an “unlawful” organization prevails even in the United Kingdom where Brits continue to work toward eliminating Unum’s government and parliamentary influence to de-socialize the country’s welfare and health programs.

Here in America, Unum’s deliberate targeting of ERISA claims and enforcement of “discretionary authority” attempts to put the American working middle class out on the street without disability benefits, and in many cases health care. Without recognizing that it is the working middle class that keeps American running, large corporations such as Unum work deliberately to “do as much harm as they can” in order to gain a few more pennies in shareholder value.

Although the original intent of the Employment Retirement Income Security Act of 1974 was to provide federal protection against employer discrimination in welfare and cafeteria plans, Republican judges have systematically eroded any legal protections decent middle class working Americans might have had in protecting their interests to fair and objective claim review. In fact, an attorney recently shared with me that it’s more and more difficult to get judges to award attorney’s fees much less win an ERISA case.

While wealthier executives, physicians, dentists and highly paid workers can afford to pay the expensive premiums for Individual Disability Protection with state jurisdictions, most ERISA folks find themselves without protection from insurers that deny claims unfairly and then refuse to overturn claims on appeal. Unum has always been considered the largest disability insurer no one should depend upon.

Working people in America need a decent break. Although the middle class carries the highest tax burden and pays America’s bills, it is downtrodden by corporations such as Unum who take advantage of claimants at every opportunity by denying legitimate, compensable claims. Claimant’s are put through a harassing, and guilt-ridden claims review process with attitudes such as, “you’re the working class….so WORK!” Also, Unum’s targeting strategies looking for the “biggest bang for the buck” put high-value reserve claims on a fast track to unsubstantiated denials.

Although middle class ERISA claimants should not allow themselves to be intimidated by Unum’s tendency to make them fearful, within a 20-minute phone conversation a Unum rep can make claimants feel guilty, helpless, and ashamed for filing disability claims at all. Unum’s biased hierarchal medical reviews and harassing calls to treating physicians often causes emotional distress to the point of creating a secondary disability called, “Unum Claim Syndrome.”

What the American middle class fails to understand I think is that disability insurers, including Unum, could not stay in business if employers turned to other less “abusive” insurers such as Mass Mutual, or even The Hartford. Employers often look for cost-effective employee benefit plans and do not   “check out” Unum’s reputation prior to setting up company benefit packages.

Employees have a right to provide employers with feedback about their Unum experience although most employees do not exercise this right. Unionized shops should clearly be informed of Unum’s “bad faith” so that Union reps can place pressure on employers to seek out alternatives at the next annual enrollment period.

Finally, claimants should never allow anyone or entity to make them feel guilty, frustrated or depressed for filing a disability claim. Employers sell disability Plans to their employees as employment benefits and insurers have an obligation to treat you and your claim as a “benefit”, not an outstanding debt. Those who stand up in support of their benefits will receive benefits longer than those who are fearful and give in to every Unum request regardless of how unreasonable it is.

Claimants can easily regain the dignity insurers such as Unum rob them of. Unum can be put into perspective and made to treat you with the respect you deserve.

It may take the middle class some time to “get their Dixie cups back”, but when they do egregious insurers such as Unum will be held accountable to pay claims fairly. Don’t allow Unum Group to treat you any less because you are an ERISA claimant and a member of America’s working middle class. You pay the bills in this country and it’s time to get a little pay back.

More Unum Complaints

Complaints(Reposts from consumeraffairs.com)

Evelyn of Portland, OR on July 28, 2015
I have been out of work since December of 2014. I have not received any pay from my employer since February. I was contacted by my employer who told me to apply for UNUM disability when I was told by my doctors that I would not be returning to work. I did so the first of MAY. I was told I would have a answer in 45 days. In 45 days I was told that UNUM needed more time to decide. I provided UNUM additional paperwork and so did my doctors. I have paid in to this disability insurance for 22 years and have yet to receive a decision from them and it is nearly Aug. I received a letter dated July 23 stating UNUM needed another 30 days. I have since gotten approval for a early disability retirement for my pension. Unum was supposed to be there for me to fill in the blanks financially until that occurred. So much for UNUM being there to pay the bills while that took place.

I wake up every morning hoping the water is still running, and the lights are still on. This insurance is nothing but a scam. I have contacted my employer and union and let them know. They have had several complaints and I will be a advocate for future contract negotiations through the union and my employer to not renew with UNUM. This is not a benefit to the employee if the benefit never comes. Unum has no intention of paying out to anyone. If they actually do pay, from what I’ve been reading it sounds like it comes with a lot of hassle, hidden agendas, and is short lived.

BUYER beware! This is not a good company and they have terrible customer service. When you call trying to get answers you get nothing but double talk. It’s like I’m standing in a used car lot surrounded by car salesmen trying to sell me a Yugo disguised as a Ferrari. It all sounds good until you drive it off the lot. Take it from everyone in these posts, this insurance is a SCAM, SCAM, SCAM. 22 years of thinking I had a Ferrari parked in my garage and as soon as I finally drove it, the wheels fell right off!

Cheryl of Berwyn, IL on Aug. 21, 2015
I was diagnosed with congestive heart failure and my heart is only pumping at 20 percent… in filing my claim I was denied and also my appeal was denied. I was told when I signed up for this if I got sick this policy would be paid. It is a 20,000.00 lump sum. I was never sent a policy and they have told me that this is not considered major organ failure as two of my organs would have to be failing and I would have to be on a transplant list to qualify… This is not what the rep told me at all. I took this policy out to protect my husband’s future as he has health issues. My condition was brought on by stress from my husband’s health issues, demands of my job, my father becoming ill and I became his caretaker while on FMLA and he died. I took this policy in good faith not thinking at 55 years of age I would be in this poor of health. They have deceived me.

Jonathan S. of Brooklyn, NY on Aug. 18, 2015
I was recently diagnose pulmonary embolism and nearly cost my life. I been paying Unum for past 3 yrs 177.90 month. Well I been home for a month now and all I’m getting is the run around. I could receive a check any minute. We expedited the claim and my bills are in a pile. Don’t know who else to talk to. I’m tired, I’m weak and don’t have the energy to fight. Soon I’m going on my second month and nothing yet. I’ll be out of work till October and really don’t know what I’m going to do with my monthly expensive and cost of living.

Holly of Lubbock, TX on Aug. 11, 2015
I have been off work since June 11, 2015. Was approved on June 24, 2015 that was 13 days. The group policy for that my employer offered waiting period of 7 days. Got about three checks. Now they are saying they didn’t have enough medical information. Why has Unum waited till August 10, 2015 that they need more information. When you’re trying to get well and all you’re doing is collecting information. Stress is not good for Reflex Sympathetic Dystrophy (RSD). I am now stressed all day long & night. I believe that we all can make complaints to the National Insurance Board & State Insurance Board. Also maybe they would do something about Unum. This is wrong when you’re ill to constantly be stressed financially & physically.

BabyUnum recently denied a claim alleging that because the claimant got married, went on a honeymoon and eventually had a baby while on claim she could return to work full-time.

Sometimes Unum’s arrogance to deny claims unfairly is so bad that its actions should be hung up on a national clothesline gone viral. What disturbs me most  is the company’s presumption that women may not engage in cultural norms, customs, or exercise reproductive rights because they are receiving disability benefits – specifically from Unum.

Let’s call this what it is – sexist discrimination!

Oh, I know the drill alright from when I worked for Unum nearly a decade ago. The presumption was that if a woman deliberately became pregnant while on disability we were to deny the claim after conducting an in-depth phone interview asking questions such as “How long are you up all night with the baby?”

Managers told us, “Taking care of an infant is a lot of physical work. If a woman tells us she has fatigue and can’t work but still has a baby while out on disability, then something’s wrong somewhere.”

It is possible for Unum to abuse its discretionary authority by alleging taking care of an infant is equivalent to “light” physical work capacity. Unum also considers “getting married” and going on a honeymoon to be indicative of work capacity.

Furthermore, Unum’s decisions to deny claims for females who have babies is wrong on so many levels, such as forcing women to take birth control, or forcing women to violate religious or cultural norms in order to receive financial help they are already entitled to.

Since when did Unum become the purveyor of cultural norms and reproductive rights for the disabled? Unum’s sexist attitudes such as, “If you are costing us money because you won’t work, then you better not get pregnant!” are unconscionable and violate the most basic rights and freedoms of families to “pursue happiness” whether or not they are receiving disability benefits from Unum.

Women’s rights and disability advocates should strongly protest Unum’s position that women should not become pregnant while receiving disability benefits. Granted, taking care of a newborn IS a great deal of physical work, but disabled women know where to get help. Dads can take FMLA leave; grandparents can care for the infant during the day; and/or outside resources can be obtained to help with housekeeping and the baby.

Disabled mothers can also ensure that their treating physicians continue to document restrictions requiring assistance with infants and children along with other R&Ls resulting from the primary cause of disability. Caring for newborns while on disability need not be a determining factor for the automatic denial of Unum’s claims. The fact that Unum makes termination decisions based on the pregnancy and delivery of babies speaks for itself regarding Unum’s sexist attitudes toward women on disability.

Unum has a large core STD business in maternity claims. The company pays for 12 weeks of maternity leave and then denies further benefits barring complications. However, Unum’s perspective changes in situations where women transition to LTD for another cause of disability and then “get pregnant.”

Unum’s defense for denying women who get pregnant is the underlying presumption that those on claim should be doing everything they can “to get healthy and back to work” rather than “everything they can to remain on claim.” Unum therefore believes that women on claim get pregnant to stay on claim for secondary gain, or to make existing symptoms worse.

It is absolutely unconscionable that Unum should be allowed to deny claims because female insureds and claimants become pregnant, or seek fertility treatments, another one of Unum’s sexist strategies to deny claims.

Frankly, pregnancy is none of Unum’s business and the company should stay out of its insureds’ bedrooms. (Unum once denied a claim because it found an insured diagnosed with depression having sex in the back of his car. It’s reports like this that really make me angry.)

The idea that “disabled persons” with open private disability claims should be denied basic human sexual interaction and reproductive rights is inhumane. Putting Unum in charge of the American morality and reproductive rights hen house is about as wrong as anything can get.

And by the way, males aren’t affected by Unum’s “pregnancy” hits since it is presumed wives are doing all the work of taking care of the newborns. Unum won’t even know if a male insured has a baby.

I have no idea where the voice of American protest is these days, but I wish someone would find it, and use it.

Friday Q & A

Q&A ButtonWill Unum deny my disability claim for picking up my child?

Well…it might. It depends on how much your child weighs and what your lifting restrictions and limitations are. If your physician, for example, is documenting lifting restrictions of not more than 20 lbs. and your child clearly weighs more than that, then you shouldn’t be lifting your child.

I know it’s hard not to interact with your children, but the process of disability claims is pretty clear. If your insurer is conducting surveillance on the very day you decide to lift and carry your child, exceeding restrictions, then yes, Unum could deny your claim. I know it seems heartless, but when a doctor provides medical restrictions and limitations, Unum takes them very seriously and can enforce them relative to the terms of your policy. Unum won’t hesitate to deny a claim because you exceeded lifting restrictions by picking up your own child.

My financial advisor called my insurer to give “notice of claim.” Now, I’m hounded for the application. Can financial advisors and insurance agents call up insurers and give “notice of claim.”

I’m actually surprised your insurer allowed a financial advisor to request forms and give notice of claim. All good intentions aside, financial advisors and insurance agents have absolutely no idea how the claims process works, nor do they realize the possible implications of giving “notice of claim on your behalf.”

I realize agents are trying to help you, but they shouldn’t get involved in the claims process at all. Some financial advisors and agents tell insureds they have friends on the inside that can help, but it never seems to pan out well for the applicant. Financial advisors and insurance agents should stay with what they do best, namely managing financial matters and selling insurance.

What is “disability brain fog?”

This is not a term I would use to describe mild cognitive difficulties in complex thinking, memory, or ability to complete tasks.

The phrase “brain fog” became quite popular during the last decade in describing symptoms related to fibromyalgia and chronic fatigue. In fact, the term became a stereotype for symptoms believed at the time to be non-existent.

Today, the term “brain fog” is almost always associated with “imagined” symptoms generally associated with what the DSM-5 now describes as mental illness and somatiform disorders. This does not mean that patients aren’t experiencing some element of difficulty with thinking clearly, memory and performing tasks, but it does suggest that symptoms should be more clearly defined rather than using the capstone phrase “brain fog.”

Some rheumatologists and physicians still use the term “brain fog” because they are unaware of how the description is perceived in the disability claims process. Not all medical professionals who still use the term have the same definition of what it means. This complicates disability decisions even more.

I recommend to insureds and claimants that they not use the term “brain fog”, but should always describe their symptoms related to fibromyalgia specifically such as difficulties with short-term memory, thinking clearly, multi-tasking and being able to make quick decisions.

I have a really awful Unum claims handler. She doesn’t listen to anything I say. What do I do about that?

Unum’s claims handlers are “trained to miss.” In other words, they are held accountable to follow-through with the company’s agenda and protocols even though they know it’s wrong to do what they do.

Claims reps focus on micro word-snatching from things you say and write, and from patient notes with a pre-determined agenda to terminate or deny claims. Claims handlers often do not listen because they know they don’t have to.

Remember that Unum’s claims process isn’t about accurately assessing disability, but about financial reserve gain and profitability. You are virtually a claim number on someone’s desktop screen.

The best thing to do is insist on all communications in writing and respond only to the issues at hand without a lengthy defense or rhetoric. Remove yourself from situations where you may be made to “feel bad” when it isn’t your fault and you’ve done nothing wrong.

Unum’s claims handlers become robotic after a while and treat everyone the same. Because they do not have the autonomy to make claim decisions on their own, they often put insureds on a pay no mind list and document everything they say in a focused advantage to the company.

It’s best to remove yourself from verbal situations all together and do something to benefit the record by insisting on all communications in writing. It’s really hard for Unum claims handlers to be contentious in letters, and if they are, it’s in the record for all to see – including a potential judge in the future.

You're firedMore and more Unum, Guardian and DMS insureds are calling DCS to inform us they are either withdrawing their disability claims, or have decided not to submit them.

I’m not really surprised since it shouldn’t have taken this long for insureds to figure out that the complexity and frustration of filing disability claims is no longer worth the premium paid.

In addition, according to the Internet, Unum’s poor reputation as an unfair insurer is bound to catch up with the company eventually. Most callers express dissatisfaction with all three companies.

I received a call late yesterday from a very interesting gentleman from the south. “My psychiatrist has been harassed so many times by Unum, including unexpected calls from their physicians, that she has recommended that I find someone else to treat me. I’ve been treating with this same therapist for nearly ten years, and because of Unum she wants to fire me.”

A Guardian insured called recently with her own story about Guardian and the harassment she’s been subjected to and she hasn’t even submitted her claim yet! Apparently, a financial advisor gave “notice of claim” on her behalf and ever since then it’s been horrific. A private investigator showed up at her door one day stating, “I was just in the area and thought I’d drop by for an interview.”

“Linda, I haven’t even filed my claim application yet, and I’m not going to”, she told me. “And furthermore, I am informing Guardian I’m letting the policy lapse. I don’t want to be involved with that kind of investigative paranoia. My health won’t take it.”

Of those who inform us they are withdrawing claims, most cite their health and well-being as the reason why they would rather give up benefits they are legitimately entitled to rather than be harassed by Unum or DMS.

“The stress of filing a Unum claim is unbearable, and I’m not going to put up with it anymore. My doctor tells me the Unum claim is affecting me and causing more symptoms.”

Others say, “I live in an area where there are limited resources for qualified mental health resources. If my psychiatrist fires me, I’ll have to travel an hour for therapy. Unum isn’t trying to help me, they’re hurting me.”

Finally, a long-term claimant shared, “My doctor told me during my last visit, ‘I didn’t sign up for this’, meaning Unum’s harassment of his office staff. And, the truth is, he really didn’t. I can understand that.”

There are those in the industry who would allege that disability insurers deliberately harass and intimidate their insureds and physicians because it is in their best financial interests to do so. Once insureds are fired by their physicians insurers can deny claims for “lack of proof of claim”, or “failure to provide.” Dropping out of “appropriate and regular care” may also be an issue while insureds are looking to replace qualified treating physicians.

I tend to lean toward management’s putting pressure on claims managers and reps to obtain medical paperwork and R&Ls at frequent intervals. This shows an executive paranoia that there might be unidentified “denial opportunities” (and profits) that remain untapped. Such protocols and upper management stressors fail to recognize the permanency of some claims and the fact that some disabling conditions will never change. “Investigation” quickly turns to “harassment” when proof of permanent disability has already been made reasonably clear.

Physicians themselves often display the patience of Job when responding to insurance companies only to bring the frequent backlash of harassment upon themselves later. Treating physicians can exercise their own authority by informing insurers they will not provide information on the phone, but will only respond in writing, and for a fee. All physicians have the right to say, “I’m not going to speak with you on the phone, but I’m happy to provide R&Ls in summary form. “

Historically, DCS has not supported arbitrarily withdrawing claims or lapsing policies because after all it’s to the advantage of all insurers that insureds and claimants do this. Companies such as Unum, DMS and Guardian benefit when insureds and claimants fire them and/or let policies lapse particularly if insureds have built up increased benefits over time due to COLA or exercising Future Increase Options.

However, I do agree that for some, when it comes to making decisions between “health” and “harassment”, filing a disability claim may not be worth it. Each claimant and claim is unique and one set of circumstances naturally would not apply to all.

I can personally attest to the fact that treating physicians are getting tired of Unum’s harassment for records, completed forms, and doc-to-doc calls. Insureds are becoming sicker because of DMS’ and Guardian’s over-the-top investigations that probe into personal privacy, and tend to define disability as an out-of-contract credibility issue.

Bottom line…….if insureds and claimants look for other alternatives to covering the costs of disability and refuse to buy policies or file claims, unfair insurers will be forced to stop doing business. More and more consumer insureds are firing their insurers and are saying “NO” to harassment that affects their future health and well-being.

British FlagI am aware that Lindanee’s Blog is read by quite a few individuals and Unum insureds from the UK, including from the Black Triangle website. I would like to have the opportunity of reviewing a Unum policy sold in the UK as well as Scotland.

I cannot believe that Unum wouldn’t offset (reduce) benefits for any government welfare received. And, since there has been quite a bit of criticism on this blog of Unum’s operations in the UK, I’d like to have the opportunity of reviewing an actual Unum policy sold in the UK. Personally, I don’t really understand why anyone with government entitlements for health insurance or welfare would buy these policies, but I’d like to take a look.

Anyone from the UK who has a copy of a policy sold to them by Unum, and can scan in and send me a copy I’d appreciate it. I’d like to audit the policy and will give a full review on this

I understand Unum stopped selling its Individual Policies in the UK in 2012, but is concentrating on its employer group product. If any employee/worker in the UK can scan in a typical policy provided by employers I’d appreciate it.

http://www.ftadviser.com/2012/03/08/insurance/health-and-protection/unum-pulls-out-of-individual-income-protection-i1gbMRG4IEQDMy93LKUFiL/article.html

Thank you.

Religious FreedomWhile most of us take our First Amendment rights for granted, some of those rights may become very difficult to take advantage of for the disabled, or those who advocate and fight for the rights of disabled persons.

For example, the insured who phoned me on Friday to say that he noticed  Guardian’s surveillance sitting outside his house and “did I think he still could attend Yeshiva and observe Shabbat” was made to feel fearful about exercising his constitutional rights to religious freedom.

The First Amendment to the United States Constitution states:

“Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”

For this particular insured, Guardian’s threatened loss of his choice of worship and expression of spirituality devastated him. He was, of course, made fearful to walk the six tenths of a mile to synagogue because he thought Guardian would surely allege he could work.

Over the years, insurers have persistently asked questions, in interviews and on forms, about Church activities in an effort to show insureds have work capacity. In my opinion, any question relating to insureds’ protected rights to worship, or to express any religious belief is off-limits to private insurers.

Sometimes Americans need to be reminded that “freedom of religion” means ANY religion. I’m frequently asked, “Linda, can I still go to Mass and stay for recitation of the rosary?”, or “My church has prayer meetings on Wednesday and Sunday evenings, can I attend? Do I have to disclose that activity?” “What about if I want to go to Confession (Reconciliation) on Saturday? If Unum is watching me, will my claim be denied because I went to Church, synagogue, or temple?”

Those who are receiving private disability benefits, and who are disabled are NOT second class citizens and still have the full exercise of the freedom of religion. Unless insureds are specifically asked whether or not they attend church, any information regarding the free exercise of any religious faith or freedom need not be disclosed.

Although insurers ask questions about the exercise of religious freedom and practice it would be extremely unwise of them to deny a claim because of surveillance taken while insureds are on their way to worship. The unrestrained right to have religious beliefs (or lack of them) and attend services by choice should not be used as a “risk management” tool to deny insureds their First Amendment rights to worship as they see fit.

In fact, very rarely is surveillance used by insurers as the only source of back-up supporting denials; there is always “inconsistency of support”, and other medical evidence indicating work capacity.

The culprit here is fear.

Fear to go outside and walk six tenths of a mile to synagogue; fear to attend Wednesday and Sunday prayer meetings; fear to get in a car and have someone drive you to temple; fear to attend Mass; fear to be a part of any organized religion and to participate in worship; and fear to participate in any organized religion.

The “wrong” if you will, is the power disability insurers seem to have to instill overwhelming fear over Americans because they can terminate disability benefits in an arbitrary and capricious manner, abusing any and all rights of the disabled to obtain what they, or their employers, paid for.

There is something wrong with private disability insurance when American corporations are permitted to assume the risk of disability, but then transfer that risk back to insureds who risk not getting paid at all. Herein lies the source of fear, not security.

Disabled Americans should never be afraid to worship or exercise their basic constitutional religious freedoms for fear of claim denials. Of course, common sense should be used when participating in church activities such as St. Mathew’s 10k walk for breast cancer might not be the best idea.

However, this post is about worship, not activity participation although I support participation in church activities as long as insureds do not over do restrictions and limitations.

Insureds and claimants can ignore surveillance vehicles and walk or ride to church with their heads held high recognizing their guaranteed rights to openly worship as they see fit. If you feel comfortable to you can knock on the window of the surveillance vehicle, hand the investigator a tract, and be on your way.

Although private insurers are allowed to instill fear in so many other areas, the right to worship shouldn’t be one of them. Of course, you can go to church and worship (or not) according to your own beliefs, customs, and spirituality.

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