Issues with private disability carriers

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DivePuppy
DivePuppy Member Posts: 29
edited December 2015 in Employment, Insurance, and Other Financial Issues

My background: Dx with Stage II IDC, bilateral mastectomy and reconstruction, bad infections, all summer of 2012. Started Chemo (carboplatin and Taxotere), Herceptin and Perjeta at the end of September 2012. Tumors were triple positive. Prior to the cancer adventure, I was a "c-level" executive at a local bank. Have not been able to work since. Neuropathy, vertigo, extreme joint pain, shortness of breath, ridiculous hot flashes and chemo brain from h***. I can't remember and I can't focus. I've had difficulty simply managing my money and paying the bills. I purchased LTD insurance through my employer when I was still working, and have been approved for SSDI. I found out in late September 2015 that the LTD insurer had stopped paying benefits as of early September because I hadn't provided them with the reams of information they had requested. It is true that I didn't get everything back to them. Part of the problem is the chemo brain; the other part of the problem is the ditzy nurse navigator at my onc's office. The insurer had everything by early October, but still hasn't resumed paying my benefit. I have an attorney (friend of a friend), but don't think he's doing much for me. I have another attorney reference and will call him tomorrow.

Those of you who deal with these issues, particularly chemo brain, know how debilitating this can be. I forget where I'm going when driving, and have to pull over until I remember, forget to pay bills, etc. My SSDI will not cover my mortgage, and the mortgage lender will not make any real accommodation until I can get my house sold. I have equity in the house, so I want to sell it vs. doing a deed in lieu or letting it go to foreclosure.

My point is not to get sympathy, or recommendations on other treatments/meds (I've tried several things). Has anyone else had these issues with your private LTD carrier? If so, how did you handle it, and how did it turn out? Thanks!

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited December 2015

    Bumping to front.

    Maybe someone who knows insurance (like BrooksideVT) will pop in.

    BarredOwl

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  • DivePuppy
    DivePuppy Member Posts: 29
    edited December 2015

    BarredOwl, thank you for your response and "bump!" I do wish someone who has been through this would take the time to respond as well. Happy Holidays!



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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited December 2015

    Well, if your believe they have all the information (and even if they do not), please give them a call. A representative will have to tell you exactly what is going on and what requirements (if any) are still needed. Do keep in mind that while they are never exactly in a hurry to pay benefits, there are limits to how much--and for how long--they can dither around. If you do not receive a logical explanation of how they are processing your claim, feel free to call your State Department of Insurance. Complaints escalated to the state guys tend to leapfrog to the top of the pile. Be advised that for some insurers, their knee jerk reaction is going to be a resounding, "No." Not to worry. They are just hoping you will go away.

    Years ago I suffered terrible vertigo. The insurer required that I see their doctor, but did not provide the correct specialist. (They sent me to a neurologist rather than an ENT.) We all went to court. It never occurred to me to bring a lawyer, but their side, of course, had one. They had the MD there too, who testified that I had passed his neurologial exam. The judge found in my favor, pointing out that my ability to do leg lifts was unrelated to my inner ear function.

    It will be very nice when you receive all those back payments in one nice New Year's bundle!

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  • DivePuppy
    DivePuppy Member Posts: 29
    edited December 2015

    Thanks so much for your response. Unfortunately, the insurance folks will only talk to my attorney, who has been basically useless. I'm in the process of changing attorneys, and hope that process is completed in the next day or so. I'm still thinking about calling our state Insurance Commissioner though. Good idea!!! Thanks again, and blessings to you during this holiday season (and beyond, of course)!

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited December 2015

    Yikes! I've never run into the attorney roadblock. You could contact a rep from the DI company. Perhaps if you either assign him/her to your policy, or have a phone call with you, the rep, and the insurance company on the line, you might have some success with finding out what the holdup is.

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