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Archive for the ‘Complaints’ Category

Colette of Moultrie, GA on
I established Unum Insurance through my employer in 2008-2011 and the both of them are very unethical. I enrolled in short-term disability insurance as well as long-term disability insurance paying into the program for numerous of years and suffered an injury that I still have until this day. I was injured at work and this company gave me the run around about my insurance until the day I was wrongfully terminated. I asked for reimbursement and they refused. They are deceitful and in the business of making money off their consumers.
(I wonder whether this claimant understood that Unum’s STD Plans do not pay for work injury covered by Worker’s Compensation. While I’m sure that Unum does not function fairly or works to PAY claims rather than deny, STD is generally not paid to employees injured at work. In fact, Unum has been handing off other disabilities as Worker’s Comp when in fact the disabilities aren’t work injuries at all! Inside information provided confirms that Unum’s STD reviews are slanted for the purpose of denying most of them.)
Bethany of Southside, AL on
They have every reason under the Sun to not pay my claim, I have received the run around. They are heartless. They do not want to pay no matter what. My surgeon and my PCP sent in all documentation to support my absence for a month, with it being an emergency surgery. No preexisting condition or anything that my policy wouldn’t cover and Unum still keeps coming up with ridiculous reasons not to pay when it’s obvious I could not work which was most certainly clear. No food on the table, had every reason to receive money from a company I have paid into every week. They do not care.
(This post really says it all doesn’t it? Unum has a very poor public reputation in both the US and Great Britain. Middle class ERISA employees have less than a 50% chance of having a Unum paid claim. The bare truth is, Unum STD/LTD coverage does not provide employees with any kind of financial security and should not be depended on long-term.)
Michael of Somersworth, NH on
Unum yet again has wrongfully deprived another sick/injured person of their disability insurance. I have 3 specialist physicians ALL stating my need for disability and yet Unum has wrongfully denied this based on their part-time primary care doctors evaluation. On top of this, there have been 3 employees including a supervisor and contracted physician that have blatantly lied (on a recorded line) about physicians letters claiming my ability to return to work when in fact none exist. The contracted physician created a written statement claiming that one of my specialist physicians stated that “pt is ready to return to occupation at full-time.” This never happened and infuriated my physician so much that he wrote a strongly worded letter back to Unum and the contracted physician correcting their lies. In my opinion, never trust anything an Unum employee tells you and NEVER pay for any services that Unum has to offer.
(I don’t know how many times I’ve written on the Blog that Unum doesn’t tell the truth. Yet, insureds seem to want to believe what they are told by the claims handlers. The truth is, Unum reps (and their Directors) misrepresent medical records for the purpose of denying more claims. And, it does make treating physicians furious. The problem is that Unum doesn’t care that the physician “wrote a rebuttal letter”; once the company has its mind make up it rarely changes even when they are clearly wrong. Employers need to do their homework and research Unum’s payment history for group STD/LTD. Once they do, most employers should refuse to do business with Unum unless they have a full service agreement guaranteeing certain levels of payment and customer service.)
Marie of Winston-Salem, NC on
My doctor put me off work for 3 weeks because of heart palpitations and the stress of my job. I was also put on blood pressure medication but we could not get it down. The claims expert informed me that I was not sick enough to stay off work. I asked him, “should I have ignored my doctor’s request and gone to work?” He could not answer, but he did say that everyone gets stressed at work, but it should not have kept me off work. REALLY!!? Why am I paying into this plan?!! THIS IS CRAZY! I was waiting on this money to pay my bills. REALLY!??
(This is a very common Unum complaint. There are two things Unum never accepts as cause for disability: 1) stress and 2) inability to drive. Unum’s internal policy regarding stress is that “everybody has work stress” and it isn’t a cause for disability. Also, Unum discounts reports of inability to drive except for “blindness”. This claims handler overstepped his boundary since it’s not up to Unum’s reps to to say someone can or cannot work. Unum’s reps are making more and more value judgments these days and that’s why DCS, Inc. recommends communications in writing only.)

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Joanna of Villa Park, IL on

While paying into the short-term disability program for about six years I unfortunately had a tonic conic seizure for the first time in my life due to stress. I was on bed rest for 3 weeks, could not move a muscle, was in pain medication (which makes it impossible to communicate with my staff or customers when it’s strong and makes you sleep all day, had to be supervised 24:7 by family, supervised showers and my mother had to do regular bedside assistance for me to ensure I don’t harm myself nor anyone else before my doctors put me on proper medication to figuring out what causes it.

The last week of April I was adjusting to the new medication due to its side effects making it impossible for me to work. I was looking for one month of pay from UNUM since that’s what I have been paying into and they originally send me one week worth’s pay. When I called in to check in the woman told me that she originally approved it but her manager went in to the system and ended up denying my claim stating I could have worked from home.

I immediately sent in an appeal with additional information from my doctor stating that working from home was revoked due to the amount of stress I encounter in my position. My neuro and regular doctor wanted to make sure I was not adding any other factors into my rehabilitation and wanted to make sure I was on proper medication before I returned to my job. Even after spelling it out for them and for them to disagree with a professional doctor is beyond disbelief! I have electroisa in my frontal lobe that are misfiring causing the seizure. Sounds like a disability to me but apparently UNUM thinks it was perfectly fine for me to go back to work the next day. Waste of money! This company is simply heartless. BTW they are also requesting that I pay back the original weeks worth of pay they sent me.

(This is an excellent case since it points out several important things claimants should know. First, Unum’s managers are still “validating” claim decisions that the DBS’ make. This reduces claims specialists to no more than glorified Administrative Assistants at the bottom rung of the gopher ladder. Any claims manager, at any time, can over rule a decision to pay. Secondly, Unum’s allegation of work capacity to work at home is an unfair claims practice since most employers do not approve of working at home, or in fact certain jobs cannot be performed at home.

Unum is also remiss in demanding a refund of benefit since the company did make a legitimate decision based on information provided at the time to pay. No insurance company has the right to make a claims decision and then change its mind because it needs to add to profit in a particular time period. This claimant has it right, “Unum is beyond belief!”)

Rachael of Irving, TX on
 

I worked for CVS health starting 4/4/2016. In July of 2016 my benefits kicked in along with the short-term disability which was taken out each pay period twice a month. Well I had surgery 3/22/2017. I was on leave of absence for 5 weeks starting 3/22/2017 and returning to work on 4/26/2017. I expected to get pay from my PTO/vacation time from CVS that I had accumulated during my leave. I did not receive any communication from Unum so I was not aware of the short-term disability kicked in 7 days after my surgery until 4/13/2017 that evening. I called Unum on 4/13/2017 but it was after hours. I received a call back on 4/17/2017 from Kayla whom was the specialist handling my claim. She told me my claim was approved through 4/19/2017.

When she told me the amount, I was like I did not receive anything for direct deposit or the Tax Form W-4. She said I could go online and submit the information. So, I did that. I called on 5/1/2017 inquiring direct deposit and the Tax Form W-4. An agent said she would put stop payment and have Kayla call me back. Kayla or no other rep called me back. I received a check anyway but taxes were still taken out and my direct deposit was not utilized. My W-4 clearly states EXEMPT. When I called today 5/9/2017 to ask about my taxes taken out, she said she will only reimburse for the last check and not first check since I didn’t get that information in before she approved the first check.

Well the first check was approved 4/20/2017 which is the day of initial contact with UNUM. I told her this is bad business practice. She told me I can do whatever I need to do. So, therefore I am writing this complaint to get retro pay back for the taxes from the first check. I wrote the BBB and UNUM did respond admitting their negligence still refusing. Be warned!

(No insurance company will ever admit to anything. The “we did nothing wrong” defense is a well-known response from Unum to anything they are accused of. Unum does not respond to BBB complaints as it alleges confidentiality issues. In my opinion, Unum insureds and claimants will have to get used to the fact that Unum is an extremely dysfunctional and chaotic insurance company. Currently, it is in the process of firing people and outsourcing work to other agencies. Nothing the company does of late is accurate or the result of good faith and fair dealing.

Another thing Unum claimants should understand is that nothing Unum reps say should be taken at face value. When the DBS’ are backed up against the wall, they will say anything. I’m sorry you had such a mixed up time with your STD, but its more normal for Unum to get it wrong than right lately.)

 
Jerry of Los Angeles, CA on

I was hit by a drunk driver 9/3/2015 and am just now trying to go back to work and this group of hateful people still have paid me less than 2% of what my policy provides. I have sold my car, my personal belongings and have gone up to five days in a row with no food because they do everything they can to not pay what they owe you. I have begged them for a check and they just don’t care. And in case you didn’t know, there is a secret website they use to upload your claim and communicate to anyone in the industry ANYTHING they want to without any regard to the truth or not.

My claim made it to that website and some person who has never met me, not spoke to me directly, attached his opinion to my claim that I was probably lying and the case was a fraud. So now I’m only a few weeks away from losing my home. Do they care I’m about to be homeless? No. Do they still think I’m lying? Probably. For your own sake, do not give these crooks one dollar of your money. And if you can, switch to any other company.

(From what I hear Unum is now training its newbies to consider all claims fraudulent until proven otherwise. I agree with you that Unum will do anything not to pay claims these days. No disability insurance company “cares” about you personally. They don’t care whether you can pay for your medications, whether you an afford to eat, or pay your bills. The only thing disability insurers care about is doing away with the financial reserve associated with your claim and having an immediate contribution to profit. I know it’s harsh to say this, but DCS, Inc. has been reporting for years that Unum, in particular, knows absolutely nothing about disability.

Today, Unum’s claims process is worse than its ever been. This claimant is correct. It isn’t worth it to contribute to premium when the chance of getting paid is very slim. Unum’s policies and Plans may not put food on the table.)

 

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Bill of Springfield, IL on Feb. 21, 2017

When they sold me this Unum critical heart and cancer insurance if I had cancer or if I had a heart attack or needed heart it would pay so I could use it for out-of-pocket expenses. Don’t waste your money on them. I had a rare surgery repositioning an artery which is found in about 5 percent of people. I had to have open heart to fix. Didn’t get a dime from them. Couldn’t even get their doctor to look at. Denied, denied. Don’t waste your money on them. You will be denied too.

(Unum began offering additional benefit riders such as hospital indemnity and critical care  insurance on their group Plans several years ago. Unfortunately, these additional Plans are contributory meaning claimants pay extra for them. I have never recommended that claimants spend the money for the additional benefits particularly when Unum “risk manages” them the same way they do its disability Plans.  For other insurers “indemnity insurance”, or insurance that pays a fixed daily rates for hospitalization or services paid directly to insureds, payments are not usually a big deal. However, like all Unum scams, the idea of risk managing “indemnity insurance” is profitable for them. I wouldn’t spend any money to buy Unum’s extra indemnity policies, as you can see they don’t pay out.)

Grace H. of Middletown, CT on Feb. 17, 2017

If I had NO disability insurance I would have been better off by far! They paid me 11,196.74 16 payments@$963.34/ea. Then took back $9,496.74 as a overpayment because they said that payments should have been only $100.00/mo — And demanded in a very threatening letter all the payback immediately. Why and who would overpay you $863.34 a month for 16 months without some kind of backhanded deal going on. You could never get real answers to questions. I won a disability case, I had a minor child, a retired husband and nowhere did I see “credits” for any of this or for the attorney’s fees either—It was a terrible time to be harassed and to be so very ill.

(No insurance company really cares about the people they sell policies to. Although this writer is unclear as to why a overpayment was due, “offsets” can only reduce benefits if the Plan or policy contract says the insurer can. Therefore, claimants need to have copies of their Certificate Booklet so they can determine what is a legitimate “offset” and what isn’t. Most of the time, though, deductions taken from benefits ARE contractual, but claimants are unaware of them. It it also very unfortunate that claimants have to deal with the issue of finances while ill and trying to manage their disability. Unum knows this, and usually takes advantage.)

Schon of Ashley, OH on Feb. 16, 2017

My former employer, Gateway Mortgage Group, offered short and long-term disability insurance with our benefits in 2016. After trying chiropractic care and physical therapy, my surgeon advised in July that I would need to have spinal fusion surgery on L5-S1 and I would also need to have metal rods inserted to stabilize the spine. Gateway advised me that there was nothing to worry about and I had the surgery in November. I knew that the first two weeks were unpaid and that the short-term disability would kick in at 60% of my pay thereafter.

From the first moment that I dealt with Unum, they were rude, dismissive, and disrespectful toward me. “What was I doing on my time off?” and “Your job is not that stressful, why can’t you work from home?” This started four weeks after surgery. It took them six weeks after my surgery to finally pay for four weeks of benefits. The following week, I received a letter from Unum stating that my claim would be denied unless I could provide further documentation stating that I was disabled. They took my doctor visit on December 12th and stated that since I was off of pain pills, there was nothing stopping me from going back to work. Being off of addictive painkillers was my choice but it does not mean that I was not in pain.

On January 4th, I told Unum that I would be seeking an attorney for an appeal to my case. I had my surgeon release me to go back (against his wishes) part-time from home on January 11th until my next visit with his office on February 6th. The attorney is still working on the case and I truly believe that Unum is one of the worst companies that I have ever dealt with. Later in January, I found a job with a better company. In my resignation letter to Gateway, I told them that they are ultimately responsible for their actions, the actions of their employees, and their third-party providers (Unum).

(The case described here is par for the Unum course. More and more reports are coming in to DCS describing rude and harsh treatment from claims handlers. I’m certainly glad that this claimant is fighting back and notified Gateway of Unum’s treatment. Unum couldn’t survive as a company without its Group LTD core products. All claimants should communicate with employers and let them know of Unum’s mistreatment.)

Michelle of Merrill, WI on Feb. 16, 2017

On November 9th of 2016 I went in for my 3rd Acl surgery. These were not work related. At that time Unum was ok with the short-term, constant phone calls and paperwork to get them to do their job, but it got done. I am a 50-year-old woman working in a factory job where I need to be lifting metal from a range of 20 lbs to 150 lbs. I worked there for 13 plus years. For 13 plus years I have paid for out of my own pocket for long-term, just in case. On Tuesday my doctor would only let me go back to work (this is after my 90 days of short-term) at light duty. My work place, which I knew this beforehand, after 90 days if I can’t make medium restrictions, cannot hold my job and at that time, let me go and issued long-term.

Today I get a phone call from a Unum representative, questioning me on my recovery and why I could not go back to work. I told her that it is not me, it is my doctor and my work, if they have nothing for me to do at light duty, so I cannot go back to work. So this very rude woman started to question me, she said, “Well we were checking out your Facebook and see that you are a very active person, and we seen you posted a picture of you zip lining on vacation.” I laughed and said, “Why yes, you did and if you are so smart to check out my pictures on Facebook you should have checked out the date and seen that picture was taken 4 years ago.”

Then she goes, “That I seen you took a vacation in January, and I seen that you were swimming.” First I said, “Well yes I did, it was a cruise, and if you look at the pictures you say you did, you will see a doctor issued brace that I wore, you also need to know it was not me so-called SWIMMING, take a better look, it is my daughter, daughter in law, son’s girlfriend, my sister-in-law and a close friend, who do you think took the pictures of them swimming?” She also questions hunting pictures that I had posted in my memories, from 2 to 3 years ago. She also question that I go to work out and questioned why I am not going to PT 3 times a week. I said that, “#1 my insurance reset at the first of the year and now it is out-of-pocket, so I cut it down to 1 time a week so I can afford it. #2, I go to work out because of me not doing PT 3 times a week, I need an Elliptical and a bike to use to get the strength back in my leg.”

She was rude and downright demeaning, I told her before I ended the call that, “It is NOT me, NOT wanting to go back to work, its work not having anything to fit my restrictions.” Maybe she needs to be calling them and asking them why? I am a very active person and life does not stop. I knew that this would be happening and was proactive and have job interviews for jobs that I can do with my restrictions. I am just amazed at how they treat people, not everyone in this world is out to screw them. It makes me wonder, because there are people worse off than me, with worse health conditions and this is how they treat people. Wow.

(Sometimes I think readers believe I’m over the top when I recommend that everyone on disability pull out of social media, Twitter, Facebook in particular. This is a very typical story about the fact that Unum actively accesses social media and uses it against their insureds and claimants whenever they can. If you have an active Facebook account please change the status to “Private” and only allow those you know about to access it. I actually recommend shutting it down entirely. And, by the way, it doesn’t make sense to me that anyone on disability would be publicizing activities on the Internet where it can be viewed, reported on, or hacked at any time by the international owners of the Internet. Be smart, and think twice about what you write on the Internet. You may as well be writing a letter directly to Unum when you do that.)

 

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Unum Complaints With Commentary

ComplaintsBill of Springfield, IL on Feb. 21, 2017

When they sold me this Unum critical heart and cancer insurance if I had cancer or if I had a heart attack or needed heart it would pay so I could use it for out-of-pocket expenses. Don’t waste your money on them. I had a rare surgery repositioning an artery which is found in about 5 percent of people. I had to have open heart to fix. Didn’t get a dime from them. Couldn’t even get their doctor to look at. Denied, denied. Don’t waste your money on them. You will be denied too.

(What Bill is talking about here is Unum’s Critical Illness insurance. These policies are generally indemnity in nature and pay specific amounts of insurance per day for hospitalization, testing, and ongoing care for specified illnesses written into the policy. Employees most often have to contribute premium in order to also have Accident, Hospital Indemnity or Critical Illness coverage.

Regardless of the type of insurance Unum offers, the company doesn’t want to pay benefits. In addition, since most other health plans already cover critical illness, it is often a waste of. money to purchase indemnity insurance, particularly from an insurance company who denies most claims. I agree with Bill that oftentimes, “Add-On” indemnity insurance is a waste of premium.)

Grace H. of Middletown, CT on Feb. 17, 2017

If I had NO disability insurance I would have been better off by far! They paid me 11,196.74/16/payments@$963.34/ea. Then took back 9,496.74 as a overpayment Because they said that payments should have been only $100.00/mo — And demanded in a very threatening letter all the payback immediately. Why and Who would overpay you 863.34 a month for 16 months without some kind of backhanded deal going on. You could never get a real answers to questions. I won a disability case, I had a minor child, a retired husband and nowhere did I see “credits” for any of this or for the attorney’s fees either–It was a terrible time to be harassed and to be so very ill.

(One of the awful things about disability insurance is that those who are ill are forced to deal with a very complex and confusing insurance process.  Unfortunately, this looks like a situation where Unum paid unreduced benefits for a period of time and then realized the claimant had some sort of offset, perhaps SSDI that wasn’t deducted. Before I repaid anything to Unum I would have asked for a reconciliation spreadsheet of all benefits paid and due.

If this situation does describe a legitimate SSDI Plan provision allowing the offset of SSDI or Workers’ Compensation, the claimant has shared responsibility to have read the Plan and know that offsets are possible. It is indeed unfortunate to find out after the fact that you owe money back when you didn’t know about it in advance. It is always the claimants’ responsibility to be familiar with their Plans and understand the offset provisions.)

Schon of Ashley, OH on Feb. 16, 2017

My former employer, Gateway Mortgage Group, offered short and long-term disability insurance with our benefits in 2016. After trying chiropractic care and physical therapy, my surgeon advised in July that I would need to have spinal fusion surgery on L5-S1 and I would also need to have metal rods inserted to stabilize the spine. Gateway advised me that there was nothing to worry about and I had the surgery in November. I knew that the first two weeks were unpaid and that the short-term disability would kick in at 60% of my pay thereafter.

From the first moment that I dealt with Unum, they were rude, dismissive, and disrespectful toward me. “What was I doing on my time off?” and “Your job is not that stressful, why can’t you work from home?” This started four weeks after surgery. It took them six weeks after my surgery to finally pay for four weeks of benefits. The following week, I received a letter from Unum stating that my claim would be denied unless I could provide further documentation stating that I was disabled. They took my doctor visit on December 12th and stated that since I was off of pain pills, there was nothing stopping me from going back to work. Being off of addictive painkillers was my choice but it does not mean that I was not in pain.

On January 4th, I told Unum that I would be seeking an attorney for an appeal to my case. I had my surgeon release me to go back (against his wishes) part-time from home on January 11th until my next visit with his office on February 6th. The attorney is still working on the case and I truly believe that Unum is one of the worst companies that I have ever dealt with. Later in January, I found a job with a better company. In my resignation letter to Gateway, I told them that they are ultimately responsible for their actions, the actions of their employees, and their third-party providers (Unum).

(I think this post really says it all. In fact, Schon gave a pretty accurate description of Unum’s claim review communicated to DCS quite often by many others. This doesn’t sound like a company that has “gotten its act together does it?”)

Michelle of Merrill, WI on Feb. 16, 2017

On November 9th of 2016 I went in for my 3rd Acl surgery. These were not work related. At that time Unum was ok with the short-term, constant phone calls and paperwork to get them to do their job, but it got done. I am a 50-year-old woman working in a factory job where I need to be lifting metal from a range of 20 lbs to 150 lbs. I have work there for 13 plus years. For 13 plus years I have paid for out of my own pocket for long-term, just in case. Will, on Tuesday my doctor would only let me go back to work (this is after my 90 days of short-term) at light duty. My work place, which I knew this beforehand, after 90 days if I can’t make medium restrictions, cannot hold my job and at that time, let me go and issued long-term.

Today I get a phone call from a Unum representative, questioning me on my recovery and why I could not go back to work. I told her that it is not me, it is my doctor and my work, if they have nothing for me to do at light duty, so I cannot go back to work. So this very rude woman started to question me, she said, “Well we were checking out your Facebook and see that you are a very active person, and we seen you posted a picture of you zip lining on vacation.” I laughed and said, “Why yes, you did and if you are so smart to check out my pictures on Facebook you should have checked out the date and seen that picture was taken 4 years ago.”

Then she goes, “That I seen you took a vacation in January, and I seen that you were swimming.” First I said, “Well yes I did, it was a cruise, and if you look at the pictures you say you did, you will see a doctor issued brace that I wore, you also need to know it was not me so-called SWIMMING, take a better look, it is my daughter, daughter in law, son’s girlfriend, my sister-in-law and a close friend, who do you think took the pictures of them swimming?” She also questions hunting pictures that I had posted in my memories, from 2 to 3 years ago. She also question that I go to work out and questioned why I am not going to PT 3 times a week. I said that, “#1 my insurance reset at the first of the year and now it is out-of-pocket, so I cut it down to 1 time a week so I can afford it. #2, I go to work out because of me not doing PT 3 times a week, I need an Elliptical and a bike to use to get the strength back in my leg.”

She was rude and downright demeaning, I told her before I ended the call that, “It is NOT me, NOT wanting to go back to work, it’s work not having anything to fit my restrictions.” Maybe she needs to be calling them and asking them why? I am a very active person and life does not stop. I knew that this would be happening and was proactive and have job interviews for jobs that I can do with my restrictions. I am just amazed at how they treat people, not everyone in this world is out to screw them. It makes me wonder, because there are people worse off than me, with worse health conditions and this is how they treat people. Wow.

(Yes, I’m hearing a great deal about Unum’s rudeness! It’s obvious the claims handlers are not caring about disabled people. I’ve said many times that Unum knows absolutely nothing about disability. This is a real shame, but DCS never recommends that insureds and claimants speak with Unum reps on the phone anyway.)

These complaints are reposted from the Consumeraffiars.com website and I added my commentary.

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ComplaintsDEBBIE of Riverside, CA on Jan. 5, 2017

I have been paying Cigna for Short/Long term disability for many years. They like their bill to be paid and even on time but when it comes time to pay on a claim Be aware you will probably not receive anything. I went out on short term disability due to a work injury. The Doctor put me on limited work status and my employer was unable to accommodate the restrictions, so I was put off of work. Cigna paid the claim after requiring me to do most of the legwork to collect the necessary documents. They paid me for 4 weeks on the claim. I went back to the MD and he said he was keeping me on limited duty because I was not ready to go back to work full time. This is when Cigna decided to stop paying me stating that I was able to work limited duty.

I explained to them that my work would not let me come back until I was at a non limited status. They said that this was not their problem. I had to put in appeal after appeal to no avail. I would call and the agent would say, “that should be covered. Go ahead and appeal,” and weeks later I would receive a letter stating it was denied and I did not have any appeals left. Later during this process I had to have surgery and was put off of work on total disability. I called Cigna and the agent said “oh yes we should cover that. Go ahead and put in a new claim.” I put in the new claim only to get a very angry Cigna representative calling to tell me I was not allowed to put in a new claim, even though the company advised me to do so.

This company tries to wear you down so you will just give up because they have frustrated you beyond your breaking point. I think to myself what if someone needed this claim to be paid to be able to eat and provide for their family. I pray that these folks that work at Cigna never have to go through this process and get denied by such uncaring workers or company. My Sister in Law had a Aflac plan and they paid for everything for her family.

(CIGNA is the one private disability insurer you may wonder why it is still allowed to exist. Paranoid to the max, this company won’t even give the last name of those who manage claims. I can see why the above claimant reached her maximum level of frustration because it has also been my experience that CIGNA’s claims handlers are always one beer short of a six-pack and have no idea what they are doing. CIGNA also calls treating physicians and if they don’t answer denies claims for “no contact” even though there is no “proof of claim” provision to have verbal conversations with physicians. In 2013, CIGNA was slapped with a multi-state settlement agreement, but like Unum, ignores it.

I’ve received several calls in the last week from CIGNA claimants and it isn’t good. In my opinion, this company should not be allowed to exist.)

Madeline of New Egypt, NJ on Dec. 17, 2016

Cigna’s process is extremely slow, stressful and exhausting and it seems as if they intentionally drag you along just to deny the claim. I have been out of work on disability since April 2016. I recently had to apply for Cigna’s long term disability. Three of my physicians have recommended and deemed me physically unable to return back to work. All of my physicians have provided completed forms in addition to office notes – (149 pgs.) However Cigna has denied the claim stated that my limitations should allow me to continue to work. I have not received any disability payment causing financial hardship.

Now that I am on long term medical leave, my employer requires that I pay my medical insurance which I am not able to because Cigna has held all disability payments. I fear that I will lose my medical coverage soon and will not be able to continue receiving medical treatment for my medical conditions. All of this waiting and their avoidance has caused financial hardship and additional stress and anxiety which are causing me additional health issues. They have left me with no other option but to hire an attorney. My treating physician are very annoyed with the fact that Cigna’s medical team can disregard their professional expertise and professional and personal experience with my medical conditions/treatment as their patient without ever seeing me.

Also Cigna’s web page statement regarding long term disability is very misleading to the consumer, “Cigna Long-Term Disability plans can pick up where Short-term Disability leaves off, with helping to ensure a continued flow of income if you can’t work for an extended period of time due to an illness or injury. You can pay bills and focus on getting well.” Cigna should be required to remove this false statement.

(False advertising in private disability is quite common. There isn’t much to say about an insurance company that does nothing right.)

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More Unum Complaints With Commentary

ComplaintsJacqueline of Mahwah, NJ on Jan. 14, 2017

I had an 18-month policy with UNUM paid for through employee deductions. Before I became ill I knew nothing about this company or their practices. My illness was of a mental nature so my policy was limited to 18 months (something HR forgets to tell you). Most policies are limited to 24 months and that is when they want you gone!

The claim represented harassed me on a weekly basis, spending 30 mins or more asking questions like: How do I spend my day, do I watch television, who cleans my house and so one. I take a lot of anti-depressants and anti-anxiety meds so I could not even think straight. They not only harassed me but sent my therapist and psychiatrist weekly questions. The rep even faxed my one doctor a form saying, “Sign this so your patient can go back to work!” The physician phoned me at home asking if I told UNUM that I was going back to work. I told him no, he said it was very sneaky of UNUM to fax this form as he is a very busy doctor and does not have time to look over every single insurance form. My therapist old me she has never ever been sent so many forms to complete and she has been in practice for over 35 years!

Yesterday, after 24 months of disability I logged on the UNUM website, apparently my claim is closed with no denial letter or explanation. I called UNUM Carrie out of the ME office but she was not available, how convenient. I asked why I could not access my documentation online and a customer service rep said he did not know and that it was just a coincidence, really.

I am quite relieved about being denied, even though I have never received a formal denial. No more phone calls from Carrie, no more harassment, no more added anxiety. I am absolutely positive they receive incentive bonuses on how many cases they can deny. How do I know? I was a no-fault adjuster for 34 years… the only difference is I never harassed claimants to the point that UNUM does. No point in getting an attorney as I think it would cost more than UNUM pays me. I will however make an Insurance Department complaint about UNUM’s practices as it borders on BAD FAITH.

(This is a situation that occurred quite frequently even a decade ago when I worked for Unum Life and UnumProvident. Mental and Nervous claims are immediately targeted and projected for denial. In fact, once coded on BAS (Unum’s pay system), Mental and Nervous Claims go away automatically, and it is possible a really ding bat claims handler would not notice a denial letter was required.

Actually, two letters are required by Unum – one about three months before the M&N denial asking if there is additional information to be considered for physical disability, and then the denial letter giving claimants their appeal rights under ERISA.

The issue of Unum contacting treating physicians and therapists to persuade them to return patients to work is. not a new one. Unum frequently contacts treating providers and proceeds to convince them patients can work. I’m glad to see here that the therapist immediately contacted his patient. Many Unum claimants actually feel relieved when no longer connected to Unum.)

Lavanya of Aurora, IL on Jan. 12, 2017

After suffering severe sciatica for years, I finally convinced myself that it was time to go for back surgery as my situation has gotten worse over the summer of 2016. I could not stand or walk for more than “10 sec”. I couldn’t sit and lay down in any position desired. It was true living hell. MRI showed Disc herniation with impingement on Sciatic nerve root. In Oct of 2016, I went for the microdiscectomy and laminectomy, during which it was found out that there were disc (L5-S1) fragments in the nerve canal causing significant narrowing of nerve canal, hence the pain and numbness in the leg. Surgery was successful. I could walk without limp, and my leg started gaining strength although there was pain from the surgery itself. It was ordered recovery for 8-12 weeks.

Ten days after the surgery, I got a call from UNUM if I could return to work. I was caught with surprise as my short-term disability and medical leave were approved through the end of the year (11 weeks) and my surgeon recommended 8-12 weeks of recovery depending on how quickly I recover. I made a call to my UNUM case representative and she tried to explain to me that note from my prior doctor’s visit (a week after the surgery) said I had no pain, hence I should be able to go back to work. Politely I explained to her that I was still on narcotic painkillers and no way I was in a position to sit and work and that I have not recovered.

A few days later, I get another mail that my claim was extended for 2 more weeks, and that I need to prove why I can’t go back to work. After making several calls (she would never answer her direct line) and number of voice mails, I talked to someone on the Main line to have her contact me. Then she called me telling that Doctor’s office didn’t send them restrictions. I asked her if she has requested the same, apparently they sent number of pages for the doctor’s office to fill and never made it clear what exactly they needed. I was extremely furious because I was in pain, disabled, and then these people made me feel insignificant and I had to convince them that I need time to recover after an illness and doctor’s order is not enough. They needed restrictions as to what was keeping me off work. Obviously “being in pain after surgery” didn’t count as a valid reason to them. What kind of insurance company is that?

I firmly told her that I was not to return to work till I had my follow-up with my surgeon in Dec. Then another mail that my claim was extended till the date of my follow-up appointment. In the meantime, I contacted my employer and HR and I explained them the harassment I had to go through at the time when I expected some empathy from UNUM. Reading from elsewhere, they do that to cancer patients too! Repeatedly asking them what is stopping them from returning to work while they go through the cancer treatment.

Finally it was day of my follow-up with surgeon. I asked my surgeon if I could go back to work, he said I could if I can. This was on a Thursday. Then I called UNUM the next morning (Friday). Again multiple calls with no response to the same agent. Left a voicemail and reached someone over the main line to tell them that I was going back to work on Monday. They asked me a series of questions, and there was the end of it. My disability claim was going to end and I was returning to work. Keep in mind that I was still recovering, just well enough to be returning to work. I was glad that I was done with UNUM. A week or so later, I receive another mail asking for documentation from Nov to Dec, proving why I had to stay off work. I ignored as I had already been working for over a week. A few days later, another mail asking for documentation, ignored again.

Then last week, another mail saying that my claim has been closed and was approved only till Dec 8 (Thursday) as last doctor’s visit note had indicated no complications and that I was doing well and that they received a return to work note on Dec 15 but they only approved till Dec 8. Dec 8 is Thursday, Dec 9 is Friday, the day of the call. Dec 10, 11 – Weekend. Dec 12 – return to work. But they only approved till Dec 8th.

It’s amazing how they think they can decide how long a person should recover post-op better than a medical provider. The vocabulary made me rethink what is “well” and what is “ability”. “Your job requires only sedentary physical ability hence, we are closing the claim.” Is pain hindrance to physical ability or mental ability? I obviously need mental ability with higher IQ and specific skills to perform my job, not just sedentary physical ability to be able to sit at desk all day long.
If you expect someone to go back to work 2 weeks post-op while on pain meds just because your job only requires sedentary physical ability, that is lame. I have no doubt someone would sue them because of their obstruction in post-op recovery and harassment they put them through.

(What Lavanya is describing here is Unum’s use of a medical recovery software called Medical Advisor that lists all possible standard recovery dates for impairments. Unum began using this software as a “stop-gap” to allow handlers to make medical recovery decisions without doing RN “walk-ins.” The program also allows claims specialists to set Expected Recovery Dates (“ERD”) without requiring someone to validate or micromanage the process. Remember, ERDs aren’t recovery dates at all, but “denial” dates.

In combination with Medical Advisor, ERDs and the “hop skip” process of STD, short-term disability quickly becomes a Unum complicated mess. Recovery software does not take into account that each individual heals at different rates and in most instances is inaccurate. Unum loves it because the recovery dates are listed at the earliest, not the latest.

The use of this software makes claims miserable for Unum’s customers because of having to explain every two weeks why they can’t go back to work.)

Harvey of Swindon, Other on Dec. 9, 2016

We had “Unum” as our Dental Benefit work provider, which was previously known as NDP which they took over from Capita in the UK. Every single claim was a hassle. If you had two dental appointments close together (I hate dentist so like to get the pain done and dusted quickly) for 2 separate teeth, they would class this a single course of treatment. Every claim was a quibble. Even though the dentist had filled in the form detailing that is was a separate filling and/or other treatment it was quibbled over, wasting the dentist’s time and my time. I would never sign up to Unum again as part of a corporate dental plan. Everything is the bottom line, no empathy, so feeling or understanding, just questioning every time every claim. Don’t bother with them, go elsewhere.

(It isn’t comforting to know that Unum’s unfair tactics jump into the management of other products as well. We all know Unum’s LTC product was a disaster that cost the company $42M in damages. This complaint points out the dangers of signing up for “Unum package” deals offered as part of an employer’s Group Plan. Products such as Accident, Life, Supplemental, Dental and Hospital Indemnity are often available to employees.

If Unum acts like a duck and quacks like a duck on its disability products I think it’s a pretty good guarantee its quackery on other products is a sure bet and not worth the extra premium.)

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Unum Complaints With Commentary

Hell noKevin of Orange, CA on Nov. 7, 2016

This company is terrible; it’s scam. They do not pay or they slow pay. I was out six weeks from work, never got a form to fill out until I got back to work. Never received a payment the entire time I was out on medical leave. Extremely disappointed with this company. Of course, it says a lot about the company that I work for having this company as a disability provider.

(Employers need to do research into Unum before it invests its dollars in employer-provided Plans that ultimately do not benefit its employees. Although Unum’s ERISA Plans may seem as though a good investment for the buck, the company’s risk management agenda entirely eliminates any benefit the Plan initially had from a cost-effective perspective. Employers should also consider that they can ask for service agreements whereby Unum would be expected to operate on a certain competency level or forfeit a certain percentage of premium. Employers may change Plans to different vendors during any annual enrollment period, and they should be encouraged by their employees to do so.)

Roger of Stockbridge, GA on Dec. 3, 2016

November 1 2016 I had a stroke and while I was in the hospital my wife filed my claim for me, so when I got out to find the hospital and I was going online to check the status of my claim Unum was send out a letter stating they needed more paperwork (Proof) that I had a stroke. So on November 16 I had went to follow up with my doctor since being discharged from the hospital and my doctor was telling me that the TPA shot saved my life because we caught it on time thank god. So that same day I called Unum and I was told that my paperwork work basically have to say I was diagnosed with a stroke which it did state that from my doctor and my medical records from the hospital.

November 18 the paperwork was uploaded to the site and I gave them time to review them so on the 23rd I called them around 3 o’clock and I was told that they received them but they was not looked over yet and was told that they will be closed for the holiday and that Friday so I was like I’ll call them Monday to follow up. Well Thanksgiving day something told me to check my claim and when I did they denied me and closed it out and gave me a reason saying they denied me cause I didn’t send them my documents showing my CT test… now in the beginning they asked for paperwork showing I was diagnosed now they on so other crap so yes it’s like that for them and I’m waiting to for my letter so I can fight this. It’s sad you pay them but when it’s time for them to kick out they come up with some bull so me and my lawyer bout to jump all on top of this!!!!

(This is one thing about Unum you have to be very careful about. Not only do the claims handlers not tell you everything they need, they take off on the holidays and leave you hanging with a denial letter they wrote before they left. Also, I never recommend to my clients that they use Unum’s portal to send information since it’s unreliable, and there are reports that there is tracking software attached to it as well. Finally, Unum’s claims reps aren’t going to advise you as to what is favorable to you. Once you understand the company manages claims with the objective of denial rather than payment you can better sift through the “fake news” the reps tell you.)

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