“…insureds can manage additional requests for information without escalating the process.”
Sure, that would be the safe thing to do, but it is also the most expensive road to take.
(I apologize in advance for the length of this post.)
After my pain doctor of 8 years passed away, I found it difficult to find and keep another, especially with opioid treatments being under constant threat of the DEA. Eventually, I moved to a different state to access a medical cannabis program to treat my 25-year intractable pain condition.
For severe chronic pain, I was required to see two different doctors to certify my medical condition for the program — to basically rubber-stamp my application, as my medical history was just not good enough for the Department of Health (which administers the state’s program). These two doctors were expensive, but not too difficult to find. They didn’t treat me for anything, just reviewed my history.
Unum says that I am not disabled unless I am being seen by a physician on a regular basis; which, all things considered, has not been the case. Which means I haven’t been able to send in the forms Unum requires for its files, like the Disability Status Update, which must be signed by a doctor. I guess this corporation also needs a rubber-stamp on my file every year or so because my almost 30-year history is just not good enough. It was good enough to prove my total disability to Social Security, and for Unum to approve my benefits 7 years ago, but not good enough to prove continuing disability to Unum. (Not to mention that Unum’s files have already been updated by my recent home visit with Unum’s field representative.)
So now I must search for a new kind of doctor, and Unum has terminated my benefits until I can find one. Now that Unum has provided more guidance as to what kind of doctor it requires, I am about to renew my search for this doctor — one who will see me for the sole purpose of filling out these forms.
(At this point, I would like to add that it would be a lot cheaper if I could see a mid-level medical provider, like an RN, for this purpose.)
And so I ask: How do I explain Unum to a new doctor without sounding totally paranoid? Like this?
“Doctor, I’m going to pay you to fill out these forms, but please keep in mind that if you misplace a comma, or use the wrong term, my benefits may not be reinstated. (And my cupboard is bare.)
And if Unum asks for additional information, be sure to charge them for your time and expenses. And don’t take any calls from Unum; but if you do, be very, very careful about what you say. And if a Unum rep shows up in person, say you’re busy. They’ll use a lot of tricks to try to trip you up, make you agree with them, so they can continue to withhold my benefits.
In fact, Unum could even try to bribe you… just like Big Pharma…
See, doctor, there was this multi-state settlement agreement because of Unum’s bad practices, but it hasn’t helped… Ummm… maybe you should just think of Unum as an enemy. Seriously, my life depends on it.”