Lincoln Financial Group is a large American-based insurance company that owns many other insurance and investment companies. In 2018, Lincoln purchased Liberty Mutual’s group benefits business (including its disability business), which provided a massive boost to Lincoln’s presence in the group disability market. The company offers both short- and long-term disability insurance benefits for various companies. Lincoln’s annual letter to shareholders extols the purchase of Liberty Mutual and the company’s focus on returns to investors.
Claims for the group protection segment are managed by in-house claim specialists and by third-party administrators. Disability claims management is understood to be critical to profitability, as results depend on both the incidence and the length of approved disability claims. In other words, if you are 45 and file a claim, expect your disability claim to be scrutinized since the potential benefits are payable for many more years.
Frankel & Newfield has worked with many claimants who signed up for short- and long-term disability benefits with Lincoln Financial. They were willing to have money deducted from their paychecks to make sure that their families were protected if they were to become unable to work. In return, many claimants report customer experiences that reflect a company that is doing its best to push back on claims.
Many claimants report that their application for benefits was met with requests for extensive documentation not required by their disability policy and been treated like tennis balls – bounced back and forth between different departments. Repeated requests for the same information, from different people, over extended periods of time, seem to be a particular strategy of Lincoln Disability. Another is saying that they have not received information. Doctor’s reports that are faxed to the number directed by a company representative are a repeated complaint. Or one person decides that the extensive medical records that have been requested are not enough and wants personal finance information that is not required by law.
The responses of a long-term insurance company claims manager to a person who is already suffering from a disability is a frustrating and infuriating tactic and the reason why many people contact Frankel & Newfield when they realize they are up against a giant insurance company that is going to do its utmost to subvert disability claims.
Our client was a successful Clinical Neurologist, practicing in the area of movement disorders in a busy hospital with a focus on complex, advanced stages of Parkinson’s disease and dementia. Her tasks required the ability to perform physical and labor intensive activities while working at an equally high level of analysis and cognitive abilities. She developed a number of complex symptoms, including severe fatigue, weakness, muscle atrophy, shortness of breath, and painful muscle cramps and spasms. These were later diagnosed as early motor neuron disease, neuron mitochondria disorder, and pulmonary insufficiency. Our client was no longer able to perform the tasks of her highly demanding occupation. She filed a claim for short-term disability benefits with Lincoln and was denied, based on a paper review of the medical records conducted by a staff nurse.
In preparing her appeal, we worked closely with our client and her treating physicians to further develop the medical support in the record, clearly documenting the tasks that her job required, and the restrictions and limitations of her illness. We vigorously attacked the credibility of Lincoln’s paper medical analysis, highlighting the many flaws in their medical review, and made it clear that they had failed to fully and properly review our client’s medical records and to understand the tasks required for her to perform her profession. We won the appeal, and Lincoln paid our client the short-term benefits that she deserved. This set the stage for her making a claim for long-term benefits. Without this positive outcome, she would not have been able to file for long term benefits, even with another disability insurance company.
The appeal was represented by Justin Frankel, a partner at Frankel & Newfield who has helped many professionals who had demanding and complex careers when their disability insurance companies have resorted to a simplistic paper review of claims. If you would like a free consultation, call Frankel & Newfield at 877-LTD-CLAIM (877-583-2524).
A number of clients, like the doctor above, come to us when they are having problems getting their short-term disability benefits paid. The business model has changed from past arrangements, and often the same company handles short- and long-term claims. The short term claim needs to be treated with great care, as it is how the insurance company gathers information that can be used to delay or deny a claim when it transitions from short- to long-term. The concept is simple: the short-term claim is an evidence gathering period. Here’s what you may not know about the long-term disability claims process that the insurance company knows:
Anyone encountering problems with their Lincoln Financial Group disability insurance policy is invited to contact Frankel & Newfield to discuss your situation. The call and the case evaluation is free.
The insurance company has all of the advantages, unless you have Frankel & Newfield on your site. Call us today 877-LTD-CLAIM (877-583-2524).
Secrets the Disability Insurance Companies Don't Want You to Know!