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Daily BuzzMost insureds and claimants probably didn’t keep up with Maine’s elections, but in this particular case, it is important for insureds to know what could happen with Janet Mills as Maine’s newly elected Governor.

To begin, this post isn’t about a political party, it’s about “the person” and what could happen to devastate disability insureds. In Maine, the Governor appoints the Superintendent of Insurance. Some of you may recall that in the past Maine had been a lead regulator in the Conduct Market Examinations of both Unum and CIGNA. As a result of the Multi-State Settlement Agreements, (at least for a while) these companies were held accountable and fined for their misconduct and unfair claim review.

In my dealings with Janet Mills as Attorney General it quickly became clear that she and Unum were very close bedfellows. As Governor, she now has the authority to appoint a new Superintendent of Insurance, I suspect might be connected to Unum, Prudential or hail from the insurance industry with strong ties to Unum.

This in itself will be devastating to those who are covered by ERISA Plans as well as IDI policies since an insurance biased Superintendent of Insurance will not be looking to investigate Unum and other insurers to the point of holding them accountable. An ex-Unum attorney as Superintendent of Insurance will be equivalent to no regulatory oversight at all.

Remember, the UNUM and Cigna Multi-State Settlement Agreements affected all UNUM and Cigna insureds nationwide, so this isn’t just a Maine issue, nor is it a political issue. In my opinion I think Maine citizens made a wrong choice for Governor in light of the possible consequences that could be damaging to insureds nationwide. Clearly, I’m focusing on possible future adverse actions affecting insureds, but this could turn out to have horrendous effects for insureds.

We clearly would not want a Unum attorney from Pierce Atwood to be Superintendent of  Insurance in Maine. The lack of regulatory control could signal increased unfair tactics and insurance bad faith nationwide.

 

 

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Lucens Gets Around

Sometimes it’s scary how much similarity there is between Unum Group and Sun Life. Unum lawyers and employees who quit camp usually pitch their tents at Sun Life Financial, the campground for Unum discontents.

As a result, many of the same unfair claims practices exist in both companies and similarities are a bit scary. Apparently, Lucens, Unum’s SSDI gopher, is also on board with Sun Life chasing the same information. Remember that disability policies do not contain provisions requiring claimants to disclose SSDI files and the same “No thank-you” should be given to Sun Life as for Unum.

I can only assume, like Unum, Sun Life is requesting SSDI information in order to calculate overpayments and nickel and dime claimants for everything they can get – an idea Sun Life probably grabbed from Unum management.

It’s OK to tell Sun Life that you prefer to keep your SSDI information private, and I highly recommend doing so.

Surveillance is in Full Swing

Several clients have notified me that they spotted the typical insurance peepers near their houses. Apparently, insurers are putting most of their eggs in the surveillance basket which is consistent with what I projected a month ago.

Please remember not to exceed your restrictions and limitations during this holiday season.

Approval Decisions Await 1/1/2019

In an effort to avoid a sudden uptake in financial reserves, insurance companies usually hold over approval decisions until after the first of year. Therefore, if you are waiting for a claims decision before year-end, you may be disappointed.

Denial decisions, however, are recorded right away to reduce financial reserves.

Insurance PTO Time and Late Checks

Most insurance employees take PTO time at this time of the year. This means there is little to no customer service available to you, and it’s likely you won’t be able to reach your claims handlers at different periods during the holiday season. Checks may be late particularly from Unum if claims handlers go out on vacation without approving benefits prior to leaving.

Although this may be the holiday season, most claims handlers won’t make the extra effort to authorize your checks. It is recommended that you call Customer Service as soon as you can if your checks are late.

Stay Off of Facebook and Social Media

All the insurance company needs is to see your face on a FB page explaining activities. DCS, Inc. clients already know to stay off social media, but it is highly recommended to readers as well. Facebook is no place to share your holiday cheer!

Another SSDI Advocate – Human ARC

Another SSDI advocate called Human ARC is out there offering advocacy for SSDI. This is in addition to GENEX, Allsup, and Advocator Group. DCS, Inc. does NOT recommend that any insured sign on with third-party advocates. The best course of action is to retain your own SSDI attorney from the beginning. Since fees are paid on contingency there is no out-of-pocket expense to you.

Even the name, “Human ARC” is a turn off, in my opinion.

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Lindanee’s Blog receives better than 800 visitors per day resulting in as many as 50 calls per week. I’m very happy to answer quick questions, but callers need to leave their contact information with my answering service so I can return calls.

What seems to be happening is that insureds call, reach the answering service, but hang up and don’t leave any information. My answering service does not record any calls and sends me your contact information by email. I try to return as many non-client calls as I can in any given day.

If you really want to speak with me I need to ask you to please leave your contact information with my answering service so that I can return your call. Hanging up multiple times won’t put you in touch with me.

I’m happy to speak with you about your claim so please let me know how to contact you, and when you would be available to answer your phone.

One conversation could make things happen for you!

Thank you!

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Daily Buzz

Dane St – Another Unum Gopher

Consistent with Unum’s outsourcing of its internal claims review process, we have yet another third-party involved in arranging for IMEs and providing notifications. My first and only contact with this company wasn’t good since no one returned my calls, at least not initially.

Dane St.’s website can be found at: site.danestreet.com/what-we-do and although the website reads as very professionally presented, the company appeared shoddy to me in dealing with the company’s representatives. The website talks about providing reviews to clients (Unum) and answering “all of the questions.”

Everyone should be getting the message now that Unum’s review process is more third-party than in-house. There are Lucens, Unum’s SS gopher, Genex and Advocator Group for SSDI, to just name a few. More and more we see evidences of errors: letters mailed late, allegations of not receiving documents etc. indicating the company isn’t paying attention to “fair and equitable review.” STD is particularly messed up and benefits aren’t being paid correctly or on time.

Lucens Authorizations

The first time I saw a copy of the Lucens Authorization to obtain information for Unum (and now Sun Life), I knew there was something wrong. I wrote a blog about it and shortly thereafter a Lucens marketing person contacted me to explain that the company was “participating” in a program at SSA to put forth their own form.

Actually, I don’t have a problem with that since at one time I contacted SSA to report Unum’s use of its own form to request SSDI files. SSA told me that parties can use any form to obtain files as long as it meets SSA’s criteria. This means that if I wanted to I could design an Authorization of my own to obtain files if I needed them. That seemed like good news. (I don’t use SSDI files, by the way.)

However, Lucens has gone to such great lengths to make their form appear to be an actual SSA form by putting the number SSA-LSS-OP1 (06-2014) in the lower right hand corner. In addition, there is a 5 inch bar code in the right margin and a 4 inch bar code on the bottom. At the top left of the form there is a device scan box. My first question would be, “Where is this information going?”, and “What information is contained in the bar codes?” “In what situation would this form ever be swiped by a phone device?”

In the lower half of the form there is a warning that is, in my opinion, a misplaced warning. It says, “I am the individual to whom the requested information/record applies, or the parent or legal guardian of minor, or a legally incompetent adult. I declare under penalty of perjury in accordance with 28 C.F.R. § 16.41(d) (2004) that I have examined all of the information and it is true and correct to the best of my knowledge. I understand that anyone who knowingly or willfully seeking or obtaining access to records about another person under false pretenses is punishable by a fine of up to $5,000.”

I looked up the C.F.R. reference and it really relates to government disclosures such as the Freedom of Information Act, and other private information going from and to the Justice department. In particular, since Lucens is the party “seeking to obtain access to records” shouldn’t the last sentence pertain to them and shouldn’t THEY be signing off on this? Claimants aren’t the ones seeking to obtain information and therefore the last sentence doesn’t apply to them.

In my opinion, Lucens’ Authorization is deceptive. It is NOT a SSA form, it shouldn’t be valid for a year, and the disclosure warning doesn’t apply to SSDI insureds, but those who are seeking the information. My advice is for claimants to consider keeping their SSDI information private and not signing the Lucens Authorization.

 

 

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Although my first obligation for time is dedicated to the clients who actually retain and pay me, I do try to return as many calls to insureds who take their valuable time to call or contact me.

Of late, I have been receiving inquiry messages from my website in addition to phone calls. The problem is that no one seems able to answer their phones when I return calls or respond to messages.The real tinker is when I hear messages that your mailbox has not been set up or is full. In this instance you won’t even know I returned your call because I can’t leave a message.

This blog was started as an offshoot to articles I wrote for Jim Mooney’s “Inside UnumProvident” newsletter approximately 15 years ago. At that time, there was so much inaccurate information out there about private disability insurance, the intent was to provide “information as least equal to that of the insurer who is reviewing and making decisions to pay or deny claims.”

I’m happy to say that the primary focus of Lindanee’s Blog is to “inform” the general public by giving accurate information about the claims process. In addition to providing fee-based consulting services, I do try to return as many calls and answer inquiries as I can.

To that end, if I call you back and you’re not answering your phone, it’s unlikely I will try a second time. A solution to this is to let my answering service know of a good time to reach you and when you will actually be available to answer your phone.

I’m happy to speak with you, but time is limited. If you leave a message because you have an important question, it may remain unanswered if you don’t answer your phone.

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In the last few months I’ve received many calls from insureds/claimants who are attempting to manage their claims on their own. During the course of our conversations it becomes evident that, due to lack of information, they may have set themselves up for denied claims. Hence their calls to me when the bell begins to drop from the tower.

Insureds describe how they’ve been having verbal conversations with their reps, asking insurers for advice on what to do, writing long letters to the claims handlers, trusting information given to them, have not read their Plans or policies, and in general, describe how well their claims have gone, until they are about to be denied.

I also know that those who read my posts sometimes tell me how fearful my articles cause them to be. At the same time, I am contacted by many insureds for advice, (even when they have attorneys), because they know I provide accurate information and won’t just tell them what I think they want to hear.

“Information” is the most valuable tool insureds have to protect themselves from a complex, deceptive, adverse private disability system that provides no long-term financial security when they need it.

Please think about this! Before you even open the cover of your policies, these documents are adverse to you. You don’t have to file a claim, you don’t have to do anything, and yet, most people are totally unaware that benefits provided are subject to “conditions” that must be met, and insurers are permitted to use their discretion whether or not to pay you. You don’t have to DO anything and yet your policies are already working against you.

Imagine what could happen when you DO actually file a claim and attempt to move through the process. Today more than ever, insureds/claimants need to know how the process works and what to do, and not do, when filing claims and moving through the process.

There are over 1,300 articles on this blog containing valuable information insureds need to know. It occurred to me recently, after another very painful call from an insured, how limited in scope Lindanee’s Blog really is.

Therefore, I’m asking the 800 or so people who read this blog everyday to share Lindanee’s Blog with others particularly those who may have need to file claims in the future. This is not an attempt on my part to solicit more business, but rather to “get the information out there” to those who need it, before they begin working against themselves and handing insurers their claims on a silver platter.

I have no stake in the ground as people do on YouTube videos. This blog isn’t monetized, and I don’t have to compete with “Subscriptions, Likes” or “thumb’s up” to get higher ratings. My only concern is getting information out to the public to prevent them from making mistake upon mistake that won’t get them a successful claim.

Therefore, I’m asking my readers to let others know where the resources are and how important information and knowledge is with managing a disability claim before it’s too late. I know my posts are uploaded to CFS/ME and FMS chat groups and websites. Please help if you have a resource my information can be referenced on.

The information contained here on Lindanee’s Blog is free and available to everyone.

A word of caution to DCS clients who sign confidentiality statements with me. DCS, Inc’s proprietary information cannot be posted or shared without my permission, but you certainly can direct others to this blog.

Thank you.

 

 

 

 

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Daily Buzz

“Cash not Care”

DCS, Inc. received multiple inquiries about Mo Stewart’s book “Cash Not Care”. As a well-known researcher from Great Britain, Mo Stewart’s book exposes Unum’s role in denying disability welfare to British citizens causing as much mayhem in Great Britain as in the United States.

According to Mo, her book  “is for sale on Amazon and various sources in the US.”

This is the Amazon link in the US.  It may be easier to type ‘Amazon books US: Mo Stewart’, which brings up the link.

https://www.amazon.com/Cash-Not-Care-planned-demolition/dp/178507783X/ref=sr_1_1?s=books&ie=UTF8&qid=1520945161&sr=1-1&keywords=Cash+Not+Care+-+Mo+Stewart

Mo also says, “If your readers want to see some reviews about the book they can see them online via Amazon books UK.  Again, it may be easier to type in ‘Amazon books UK: Mo Stewart’, which brings up the link and all the customer reviews of the book.”

https://www.amazon.co.uk/Cash-Not-Care-planned-demolition/dp/178507783X/ref=sr_1_1?s=books&ie=UTF8&qid=1520945359&sr=1-1&refinements=p_27%3AMo+Stewart&dpID=51DT443HvCL&preST=_SY344_BO1,204,203,200_QL70_&dpSrc=srch

 

 

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