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Posts Tagged ‘Unum’s unfair practices’

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Unum Firings – No Job Security

Unum insiders continue to report the company is still terminating employees, mostly women over 50. Unum is well-known for its terminations of mature women spanning a decade or more. The company’s mantra is to target females over 50 by padding personnel files with issues alleging “poor performance.”

Unum isn’t the company for females looking for job security. Current employees continue to report lack of upward mobility for most claims personnel. In addition, Unum does not approve employee FMLA and STD claims even for its own. Instead, employees who go out on medical leave are quickly disposed of through the auspices of “poor performance.”

Unum is NOT a good place to work since claims handlers are repeatedly forced to watch their backs in addition to performing jobs that are extremely stressful. My impression when I actually worked for the company was that those who picked the toenails of managers were promoted and pushed ahead even though most were one taco short of a combination plate! Hence, Unum’s frequent lack of knowledgable leadership.

Unum’s continued fast forward to outsource most work leaves little expectation of job security for those who remain employed, at least for the time being.

PA1959Pennies From Piggy Banks

Unum insiders are also reporting the company’s “hunt and peck” for SSDI monies owed may be including COLA specifically excluded as an offset in all ERISA Plans. It’s unclear how complicit Lucens is in the scheme to find “a dollar here, a dollar there” overpayments.

Claimants should always request Unum “to prove it” [overpayments] before agreeing to pay back any money. Requesting SSDI 1099s does not separate gross benefit from COLA; therefore, it’s a mystery why Unum even requests the 1099s.

Still, there is usually no logic to Unum’s schemes other than to bolster profitability. Unum should always be asked to “put up, or shut up” when it comes to allegations of owing money. The Financial Department’s efforts to hunt down pennies out of SSDI award piggy banks is an indication of how badly the company may need the money.

“It’s All In Your Head”

All in your headThere are also recent reports that Unum Group fully intends to use the “self-reported” language in its Plans and policies to deny claims particularly for fibromyalgia, chronic fatigue and possibly memory and cognitive issues, Lyme disease, depression, and any other impairment it can throw under the bus.

Anytime a disability insurance company reviews claims with an objective of denial rather and approval, it can be reasonably said the company is engaging in unfair claims practices. To seek out legal support in various states that will support such tactics is a deliberate effort to target certain impairments and classify them as “self-supported.”

Fibromyalgia and chronic  fatigue have always been challenged (particularly in the UK) as “fake” or “somaticized” impairments. The new DSM 5 suggests that anyone who is worried or preoccupied with anything that’s wrong with them is also crazy. Clearly, one has to question the classification of somatic illness when it’s defined as worry, preoccupation and overindulgence with symptoms imagined or real.

Seems to me the current DSM 5 definition of somatic syndrome leaves the door open to classifying nearly everyone as mentally ill. Needless to say, it looks as though Unum is back to its nasty tricks of alleging physical disease is “all in one’s head” in order to avoid payment.

corporate theft SSDI Hold Ups For Repayment

Unum’s Financial Services Department does not get a gold star when in comes to chasing down SSDI overpayments from claimants. Representatives are pushy and demand repayments via threatening letters and demands for repayment.

This particular issue was brought to my attention when demands for repayment of SSDI money not received crossed the line of fair review. First was a situation wherein Unum’s reps attempted to use, “Well, SSA usually makes a decision in 4-6 weeks and your application is over 3 months old….we’re going to offset your benefit with an estimate” as a threat.

Second, Unum demands repayment under threat of offset even when the claimant hasn’t yet received any money from SSA. Claimants cannot pay what they do not yet have, simple as that. Yet, claimants are often penalized with offsets prior to receiving any actual money to pay back.

Is Unum really that hard up for money? The company’s new tactics and objectives are about as far away from good faith and fair dealing as they can get.

 

 

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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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stop-claimsAs if Unum doesn’t have enough unfair claims practices and strategies, the company seems to be “suspending benefits” in order to compel claimants and insureds to do what they request, when they request it. Ignoring the fact that physicians and others involved in the disability claims process do not work on Unum’s timeline, the company is now sending out letters, suspending benefits until insureds comply, or until the company decides to pay.

Technically, a “claim suspension” or cessation of payment is not a claim denial and therefore the claimant is denied appeal rights during the period of time benefits are not paid. In my opinion according to the policy contract itself, any insurance company is required to pay claims (assuming insureds meet the definition of disability) until such time as there is sufficient proof to deny. Contracts do not stipulate in the policy document that insureds can “suspend” benefits.

There is always a danger with Unum that once benefits are suspended, the company will require a preponderance of proof of claim to its own satisfaction, and deny reinstatement of benefits even when insureds provide whatever it was Unum requested. As many of you know there are times when its unclear whether Unum ever receives enough proof of claim to pay claims. It concerns me that Unum may exercise its own conflict of interest and keep “benefits suspended” forever leaving insureds without recourse at an appeal level.

Another concern is that Unum could “suspend benefits” even when it’s requests are unreasonable, burdensome and impossible to provide. The most recent example is Unum’s request for 10 years of personal and business tax returns when neither the IRS nor insureds are required to keep tax returns that long. Claimants don’t get paid, but Unum leaves the door open to provide the information for possible reinstatement. Of course, insureds can’t provide what doesn’t exist leaving Unum to benefit by its own unreasonable requests.

Insureds with suspended benefits should always provide the information requested by Unum, but if benefits are not immediately restored, insureds should find themselves a good attorney and file an appeal. In my opinion, there is a line that is crossed when suspended benefits are not immediately restored after requested information is provided.

Unum has contractual obligations under the policy to either pay or deny claims. “Suspending” benefits is an out of contract pay status that could leave claimants with unpaid benefits indefinitely at Unum’s discretion.

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Kidding meLately I’ve been hearing a great deal about Unum’s use of the “what changed defense”, and frankly I had hoped that Unum’s management recognized the error of its ways and stopped using it. Unfortunately, it has cropped up again in situations where employees have diagnosed illness, but continue to work for extended periods of time.

Unum’s contradictory position should be obvious. On the one hand the company puts forth that a diagnosis doesn’t equal disability, and yet on the other hand makes inquiries as to why someone can work with a medical diagnosis, but then suddenly stops and files a disability claim. You can’t make both of these arguments at the same time.

It is true that receiving a medical diagnosis does not mean the person is disabled and can’t work for private disability purposes. There are many working employees diagnosed with various impairments who continue performing their material and substantial duties while at the same time managing diabetes, fibromyalgia, MS, and quite often high levels of chronic back pain and fatigue.

Most employees, particularly in our current economy, will “suffer through” remaining on the job for financial purposes until their medical conditions worsen to the point of not being able to work at all. Doesn’t that make sense? In fact, it’s reasonable to say that nearly every person working would remain on the job until such time as a physician recommends they stop working, or employers push them to file for disability.

The fact that Unum asks the question “what changed” is not even contractual. Policy and Plan definitions of disability use basically the same language and define disability as the “inability to perform the material and substantial duties of your own occupation.” The policy doesn’t say, “for only catastrophic events” because it would mean the policy paid for “injury”, not “sickness.”

“Sickness” is most often a gradual progression of worsening symptoms that leads to disability, as well as catastrophic events such as heart attacks and strokes. Unum’s policy definitions do NOT require “a sudden medical event” to take place in order to qualify for disability benefits.

So why does Unum keep asking the “what changed” question? What is the company trying to say? Does Unum really mean to infer that employees should “put up with” potentially harmful disease, risk injury to themselves and others, and endure pain and suffering, but remain on the job at all costs, even when their physicians tell them to not work?

I have always thought Unum’s “what changed” defense as quite silly and far-reaching. Unum insureds and claimants are not unlike other disabled persons who remain on the job as long as possible until it becomes obvious that working is conflicting with health and well-being.

In prior posts I report that Unum actually knows very little about disability, and the “what changed” defense is yet another indication of that fact. Asking “what changed” is not unlike a “Twinkie” defense and has absolutely nothing to do with meeting the definition of disability or not.

In the end, “what changed” is a very silly and far-reaching question to ask someone who is disabled and filing a claim.

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