Re: Re: Re: Whats the deal with UNUM?

Subject: Re: Re: Re: Re: Whats the deal with UNUM?

Comments:
: : Thanks Ken! But after all the paperwork I submitted to UNUM, they still do not have sufficient medical evidence to approve my claim...What did they do...they went back to the same doctors and asked for the same exact paperwork I had submitted. To me, they (UNUM)sound like their prolonging the claim, almost to the extent of hoping I will give up! : : FYI-This has been going on for 3 months! : : : : : FROM: KEN YOUNG : : : My input to you is, "don't jump the gun". : : : In the US insurance regulations require a company to provide you with information why your claim has been denied. : : : A statement by an insurance company that the : : : reason for the claim denial is "insufficent medical evidence" usually means that they are having a problem gathering information to pay the claim. : : : If they provide you with the information that a doctor or hospital or whatever is holding up the claim, then I would suggest you get on the phone and call the person who handles the claims at the doctor's or hospital's office. : : : That is the person who you need to read the riot act to and if they do not comply with your demands, then it is time to have an attorney write to the doctor, hospital or whatever. : : : Don't forget to gather all of the bills you indured to prove that you have submitted a legitimate claim to the insurance carrier. : : : "Insufficient Medical Evidence" usually means most of the times that the request by the company to either a doctor or hospital for your medical information has not been received by the company. : : : My experience has been that there are some doctors who refuse to release information to insurance companies if there is an outstanding balance due prior to a claim submitted but I am not inferring that is the situation in your claim. : : : You need to contact the claim division of the company using the information I have provided to you above and ask them to be more specific if they mean a doctor or a hospital or whatever. : : : The claim division is required to provide you with that information but can also require you to make your request in writing. If that be the case, simply mail the claim division a Certified Letter requesting the information. : : : In reality and based upon what you have stated, the claim division is not denying your claim outright, all they are saying is that there is insuffieient : : : There is one other bi-product of this information. As in the case of life insurance also, an insurance company is not required to inform an applicant why they have been turned down for an insurance policy giving them the specifics. : : : In those instances you will usually find that a insurance underwiting department will simply say that information received from your doctor of the hospital or whatever makes you inelligible for the plan. : : : Then it is up to you to contact your doctor, hospital or whatever to inquire what information they reported to the insurance company. : : : By the way, don't feel sorry for a doctor of a hospital or whatever. They are paid a fee equal to a patient visit to complete the APS (Attending Physician's Statement) form even though you did not visit with them. : : : Glad to be of service to you on this message board. : : : Ken Young : : : --------------------------------------------------

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