Everyone has the right to verify calculations made by disability insurers. Although insureds and claimants should always verify the accuracy of benefits paid, residual earnings, SSDI repayments and COLA, they rarely do. How do you know Unum is getting it right?

Recently, a client asked for verification of the Unum Cost of Living Allowance she was paid. In checking her policy provisions it indicated a CPI (Consumer Price Index) would be used up to 4% of monthly benefits. In order to verify the amount of COLA paid we need to know the index that was used and actually see the calculations so that the amount can be verified.

According to Unum’s claims handler actual calculations aren’t available. Figures are “plugged in” on pre-programmed worksheets and results exit the other end. No where is there an actual calculation for anyone to review. The same is true for calculations of residual earnings. Of course I asked the question to which I never really got an answer to, ” Can’t you refer this to your CPAs who can tell us how the COLA was calculated?” I guess not.

Shouldn’t insureds and claimants have the right to receive calculation verification showing how various payments and/or additions to benefits were calculated? As a consultant I’m always looking for computations of what constitutes “gainful” in any occupation investigations, but those calculations are not to be found. Isn’t it common in the practice of business to verify mathematical computations and not just assume the other party got it right?

Why is it that insureds and claimants are always placed in a position of “not knowing” or “not understanding” what is due and payable to them? I can understand businesses attempting to make things less time-consuming and costly, but when it involves money and the payment of benefits, insureds have a right to know how Unum “got that figure.”

Even consultants and attorneys can’t verify Unum’s calculations until we see what inflation index was used. Of course, these indexes change every year as well. If all claimants are given is a summary sheet, how can anyone check to be sure they are paid correctly?

Other than getting it in the record that actual calculations were not available for reconciliation, if Unum can’t give you the answers there’s nothing else that can be done. This doesn’t mean insureds can’t challenge Unum’s math, but it does mean you won’t be provided with specifics as to how certain figures were obtained.

Are you kidding me? Unum isn’t exactly the company “you can trust” in the first place. This is the kind of information that should be forwarded to employers and state departments of insurance. There has got to be a better way Unum can provide calculation worksheets to verify their computations. It’s just good business to be able to stand behind what you pay.