Saturday, 7 September 2013

Is Your Health Insurance Company Playing Fair?

Today's post from (see link below) looks at the activities of the international insurance company UNUM when it comes to disability claims from people living with HIV. It is clear in this day and age of economic crisis that all companies who may be paying out on the basis of ill-health and inability to work are looking for every possible means of not doing exactly that. This frequently means that people with genuine illnesses preventing them from being able to work, come under suspicion that they are somehow trying to defraud the system. UNUM is by no means unique in aggressively disputing HIV disability claims but this article highlights them as a major player. Of course, we all know that certain people will try to take advantage of any system that may pay out when ill-health is concerned but the vast majority of people are genuinely trying to claim what is their entitlement and what they have paid premiums for. All anybody is asking for is a level playing field and it is incumbent on firms like UNUM to be aware of the genuine problems that living with HIV can bring and assess based on facts and not assumptions. Too many people are being given parameters that are impossile to fulfill and losing out on benefits because they are being unfairly judged.

Unum – Targeting HIV/AIDS Insureds On The Internet
April 2, 2013 by lindanee

Lindanee's Blog
By and For Those With Private Disability Claims
”Search and find the weakest of us, and therein lies our strength.” Linda Nee

Since its inception more than 10 years ago, DCS, Inc. has been an advocate and supporter of those diagnosed with HIV/AIDS who have applied or been denied benefits by private disability insurers. Insurance companies such as Unum have long treated HIV insureds as vulnerable cash cows. With today’s modern medical advance technology, AIDS is no longer a death sentence giving those with the disease normal lifespans, and of course in Unum’s view, work capacity.

The development of life-saving HIV “cocktails” does not take into account the long list of HIV-related symptoms and diagnoses which continue to rob insureds of their quality of life. Regardless of the success and invention of better drugs and treatments for HIV patients there are often physical side-effects from medications taken, and in combination with other immunosuppression diseases, HIV continues to rob a large percentage of those affected with HIV from the ability to work and sustain full active lives.

Those who suffer from HIV/AIDS often report continuing symptoms of severe fatigue, unrelenting diarrhea, peripheral neuropathy, dizziness, and cognitive deficits. My research seems to indicate individuals with T-Cell counts of 500 and above are capable of normal functioning depending on combinations of medications taken and the severity of side-effects.

Although it is possible for HIV patients to live normally, these same individuals would never be able to consistently sustain full-time work. Those with T-Cell counts under 500 are susceptible to life threatening bacterial infections and are medically recommended to stay away from social contact such as work environments. Severe, unpredictable fatigue and the necessity of finding bathroom facilities quickly would make it impossible for anyone affected by AIDS to sustain work of any kind.

Over the years Unum has had many project focus days targeting HIV/AIDS claims. A few years ago, I read several of Unum’s internal medical reports recommending return to work for HIV patients with T-Cell counts as low as 200. These same Unum insureds had also provided Unum with medical evidence of severe peripheral neuropathy, and cognitive dysfunction. One Unum HIV medical review criticized the insured because he was able to travel to his second home in Texas. Clearly, Unum periodically targets the “weakest of us” whether it is HIV, heart disease, chronic back pain, or even cancer.

Of course, the Internet information highway in combination with Unum’s “snoop moles”, fuels and arms Unum with data which for the most part is inaccurate and ill-serving. Unum’s current trend is to search the Internet for HIV/AIDS related non-profit organizations and find out who is submitting articles for publication. Potentially unreported income “red flags”go up, and Unum’s claims handler’s begin investigations looking for income never received, and occupations that are merely volunteer efforts to contribute on an “as able” basis.

Unum’s first inappropriate accusation to HIV individuals who voluntarily write articles for AIDS supportive publications, is “You’re working, and you are a writer.” What follows is a long list of accusatory questions such as, “How many articles have your written? How much money have you made in the last 5 years? “Submit all of your tax returns…” “Who is your employer?” Good grief, sometimes I wonder at the intelligence of people working for Unum these days.

The voluntary submission of articles for pro-HIV/AIDS publications is NOT the same as having demonstrated physical or mental stamina, or for that matter the ability to perform full-time work. In addition, articles published on the Internet are largely unpaid and therefore there is no income to report. Further, the authors certainly are not professional writers. A professional writer must “write” every day and meet deadlines on an ongoing basis. Those with HIV can’t do that, and Unum knows it.

There are no employers; no income to report; and certainly those diagnosed with HIV do not suddenly turn into professional, free-lance writers because they are able to voluntarily submit an article for publication every now and then. My experience with assisting HIV/AIDS insureds is that as a group they feel a moral responsibility to assist others affected by the disease. And, they have a right to do that, whether they have Unum disability claims or not.

Unum as a company has always targeted HIV claims on a periodic basis. Insureds and claimants are frequently stricken by fatigue, have very low stamina and certainly are not capable of engaging in conflicts with a major disability insurer. HIV insureds receive frequent phone calls from Unum reps along with harassing requests for updated information. There appears to be a definite visible Unum paranoia concerning HIV insureds and their ability to work.

Nevertheless, as an organization Unum Group remains the only disability insurer to my knowledge which outwardly manages HIV AIDS related claims with a clearly visible bias resulting in prejudicial decisions which are largely not supported by the medical community. After all, HIV patients with T-Cell counts of 200 cannot sustain full-time work, nor should they be denied disability benefits just because Unum says they can.

In the last 11 years DCS, Inc. has developed an expertise in managing HIV private disability claims, but our success is more than just expertise. As a disability consultant, I’ve learned that our strengths as human beings often come from the weakest among us. I would not be in the business I’m in if I didn’t think so.

Unum Group is wrong in its unconscionable targeting of HIV claims and as long as DCS, Inc. and NCDI are going-concerns we will continue to offer our services to those affected by HIV. Unum’s lack of any moral, ethical, or regulatory accountability for its actions continues to pinpoint the company as a modern insurance rainmaker for those suffering from HIV.

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