We have written about Unum, arguably the most notorious disability insurance company, in great detail. However, we realize that many physicians and dentists may not know very much about other disability insurance companies, including those whose policies they own. In the next few posts, we’ll profile some of the most common doctors’ disability insurers.
Company: Massachusetts Mutual Life Insurance Company, a.k.a. MassMutual.
Location: Springfield, Massachusetts.
Associated Entities: Mass Mutual Financial Group (parent company), C.M. Life Insurance Company, MML Bay State Life Insurance Company.
Assets: Over $195 billion in 2013.
Notable Policy Features: As part of its product offerings, MassMutual sells own-occupation disability insurance policies to physicians and dentists. One notable aspect of some MassMutual policies we’ve seen recently is an especially restrictive definition of “Total Disability,” which we sometimes refer to as a “no work” own-occupation definition. Under the “no work” own-occupation definition, an insured is Totally Disabled if he or she is unable to perform the material and substantial duties of his or her own occupation and not working in any occupation. Unlike traditional own-occupation policies that allow a physician or dentist to collect total disability benefits and return to work in a different occupation, this one will not pay total disability benefits if the policyholder is doing any type of gainful work.
Claims Management Approach: MassMutual is a highly successful insurer. In June 2014, it was ranked number 96 in the Fortune 500. However, Fortune reports that MassMutual is currently experiencing a dramatic reduction in profits. If MassMutual follows the current trends in the disability insurance industry, we believe it will increase scrutiny on disability insurance claims in order to try to regain its former profit levels.
In our experience, one of the ways MassMutual aggressively approaches claims is to hire a medical consultant to evaluate claimants’ medical records. The consultant then tries to insert himself or herself between the claimant and the treating physician, writing or calling the treating physician and suggesting treatment methods that, in the consultant’s opinion, will get the claimant back to work as soon as possible.
These profiles are based on our opinions and experience. Additional source(s): MassMutual’s 2013 Annual Report; Fortune 500 2014; Bloomberg.com
Whenever you file a claim for benefits with a disability insurance company, you will be asked to complete numerous forms. One of these forms is always a HIPAA-compliant Authorization. This form is titled differently depending on the insurer in question, for instance:
- Authorization to Obtain Information (Guardian/Berkshire)
- Authorization for Release and Disclosure of Health Related Information (Sun Life)
- Authorization (MetLife, Unum, Northwestern Mutual)
- Authorization for Release of Personal Health and Other Information (Principal)
- Authorization for Release of Personal Health-Related Information (MassMutual)
Claimants often sign the Authorization with little more than a quick glance, unaware of the broad power they are giving their insurer to investigate nearly every aspect of their lives. This may seem like an exaggeration, but take a look at this paragraph from an actual Authorization form required by one of the leading disability insurers for doctors and dentists.
Many claimants think that the Authorization simply allows the insurer to collect medical records. However, this Authorization, like those we typically see from other disability insurers, lets the company request all kinds of documents from all kinds of people and agencies. It also allows various company representatives to speak directly with numerous people in a claimant’s life. Let’s examine what you would authorize by agreeing to this one paragraph:
Continue reading Authorization Forms: What Information Are You Releasing to Your Disability Insurer?
Disability insurer Massachusetts Mutual Life Insurance Company aka MassMutual Financial Group has for the first time in its 162-year history opened a West Coast business center. The new 60,000 sq. ft. center is located on Black Canyon Highway near the I-17 and Peoria Avenue in Phoenix, Arizona and will employ as many as 400 people. Arizona Governor Jan Brewer and Phoenix Mayor Greg Stanton were among those on hand for the ribbon-cutting ceremony of the facility on October 16, 2013.
MassMutual CEO Roger Crandall told the Arizona Republic that the new Phoenix center will primarily serve customers and policyholders in the Western U.S., allowing for faster expansion and also mitigating operational risks to the company through diversification of the location of its resources and staff. During Superstorm Sandy, we blogged about the temporary shutdown of many of the disability insurance companies located on the East Coast, including MassMutual, Unum Group/UnumProvident, The Hartford, New York Life, and Berkshire Life/Guardian Life. With locations now in Arizona as well as Massachusetts, the company may be able to avoid a situation where its call center and other operations, such as issuance of disability benefit checks, are suspended due to a natural disaster.
MassMutual employs approximately 6,700 persons nationwide, including nearly 3,500 at its Massachusetts headquarters, which is currently in the midst of a major renovation. Roughly 25 employees have been transferred from MassMutual’s headquarters to the Phoenix facility and an additional 70+ employees, who were a part of The Hartford’s Retirement Plans business prior to its $400 million acquisition by MassMutual in September 2012, will become a part of MassMutual’s Phoenix staff. To round out its staff, MassMutual has announced plans to hire an additional 200-250 employees in the Phoenix, Arizona area.
According to the Arizona Republic, MassMutual has approximately 25,000 clients in Arizona and parts of New Mexico holding roughly $4 billion dollars in insurance coverage. While we are hopeful that MassMutual’s Phoenix facility will bring improvements to MassMutual’s disability insurance claims service, we would also advise disability claimants that having an additional 400 MassMutual local employees could also mean increased and potentially intrusive surveillance.
Almost every disability insurance policy issued today requires that you are under the regular care of a doctor in order to be eligible for total disability benefits. However, for permanent medical conditions, sometimes additional treatment just isn’t necessary. For instance, if you undergo a spinal fusion, no amount of treatment is ever going to restore you to exactly how you were before. In addition, people with disabilities are often in a financially vulnerable position, and paying for unnecessary medical treatment can cause further strain.
The people that write and sell disability insurance policies understand this, so they often include an additional benefit in the policies: a waiver of the medical care requirement when treatment is no longer needed. This reasonable provision helps sell policies.
Unfortunately, once a claim is made, the companies are often unwilling to actually provide the benefit. What many insureds may not realize is that the language of these waiver provisions is designed to give the company wide latitude in determining whether or not to provide the benefit.
Continue reading Should Your Disability Insurer Still Require Medical Treatment?