Brooklyn, NYYou could say that Ana is pro-active. After waiting one year after approval for Unum Insurance (formerly Unum Provident) to pay her benefits, Ana contacted government officials on every level. Five days after she received a letter from Governor Andrew Cuomo, Unum sent her a check.
“I wrote letters to New York Senator Chuck Schumer; our local council rep; the speaker for the people; Channels 1, 2, 4, 5, 7 and 11 news stations; and I even sent a letter to President Obama,” says Ana. “Bill de Blasio, Public Advocate for the City of New York, replied but said he couldn’t help because it wasn’t his department. He did, however, refer me to someone else. Then Senator Schumer cc’d me on a letter to my council rep and he called. I brought him all my paperwork and his office wrote a letter to an insurance ombudsman. Then Governor Cuomo sent me a letter.”
Ana bought her Unum Provident health insurance policy 20 years ago; as an independent she paid $118.46 per month. Last July, while on vacation, she had a fibromyalgia attack. As soon as she got home Ana saw her doctor, who told her to stay off work for at least six months. Next up, she applied to Unum for disability benefits.
With a little help from the powers that be, Ana received long term disability benefits from Unum, albeit one year after she applied. But her problems with Unum were not over.
Ana was told by an Unum rep that her disability benefits would only last for two years because her policy stipulates that a mental disorder can only be paid for 24 months. Unum was disregarding her neurologist and family doctor medical reports and instead going on her psychiatrist’s reports. However, fibromyalgia is not a mental disorder. So how can Unum insist that fibromyalgia is a mental condition?
“Of course a side effect of fibromyalgia is depression, which is why I sought psychiatric help,” says Ana, age 60. She was diagnosed with the disease about three years ago but had the symptoms for the past seven years.
“Unum first approved my benefits because I have fibromyalgia, so they have to pay me up until I turn 65, as my policy states,” Ana explains. “By denying me—only paying me for two years--Unum is saving over $100,000 (I get about $36,000 per year).
“Ironically, Unum is my biggest stress and that feeds into my depression,” she explains. “When I get a call from Unum I lose my hair and my cholesterol count soars from the stress.
An Unum representative went to Ana’s house. “He was here for two hours and noticed all my equipment that I need to exercise; certain things in the shower such as a small chair to sit. He saw my medications. And of course Unum has my medical reports.”
Ana told the Unum rep that she was not happy with this outcome and intended to fight their decision to only pay her long term disability benefits for two years.
“I spoke to my attorney and he said that if I don’t hear from Unum by mid-November we will go to court,” says Ana. “ And I am prepared to do that. I told my councilman that, after my day in court, I want to be instrumental in changing certain laws regarding the way insurance companies deny their policy holders. The main issue is how Unum gets their own medical examiners to go against your doctor’s diagnoses. I have done so much research on this company. They don’t want my family doctor to fill out monthly reports; instead they only want my psychiatrist reports.
"After this has settled I want people to sign a petition so I can go to Congress and fight Unum’s bad faith practices, even if I have to get there in a wheelchair."
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