People who are dependent upon their long term disability insurance policy benefits know the feeling: an envelope arrives in the mail, or an email arrives in their inbox, from a company with a name they haven’t seen before. It’s that sinking feeling, when you ask yourself, what now? Sometimes the letters bring dire news of a claim being denied, or a request for more information, or, in this case, that a different company that will now be processing their claims.
We like to keep our constituents informed of changes in the disability space that concern claims administration, so that maybe we can spare you a little anxiety. Matrix is a TPA – third party administrator – that is often tasked with handling long term disability claims for self-insured policies. It’s similar to Sedgwick, which we have written about in the past.
The combined companies will be known as Matrix Risk Management Services. So if that shows up in your mailbox, you’ll know who it’s from. This is a big company, with more than two million employees and it’s a sister company of Reliance Standard Life Insurance Company. Reliance is part of an even bigger company – a “member” of the Tokio Marine Group, owned by Tokio Marine Holdings, Inc., a publicly owned Japanese company and the largest insurance company in Japan. The company enjoys a good rating from A.M. Best, but what is good for the company may not always be good for claimant.
One of the on-going concerns of our disability practice concerns the inherent bias from doctors who are paid by insurance companies to evaluate claimants. It’s in the doctor’s best financial interest to represent the insurance company, who pays them and feeds them significant business, and we feel they cannot possibly provide an independent opinion on the medical status of the claimant.
The same is true for a TPA owned by an insurance company; it’s in their best interest of the administrator to limit the exposure of the insurance company or employer on a self-insured claim. How can they possibly administer the claim without any build-in bias against the claimant?
These two challenges are part of the disability claims landscape that we battle every day. If your disability claim has been denied, or if you are preparing to file a claim, don’t go it alone. Call our office at 877-LTD-CLAIM (877-583-2524) to find out how we can help.
