Attorneys for Mutual of Omaha Disability Claims
- Mutual of Omaha Reverses Long Term Disability Benefit Denial
- Mutual of Omaha - Disability Insurance Benefit Denials, Appeals, Lawsuits & Claims
Disability claimants are often seeking information about Mutual of Omaha long term disability reviews. We have created this page where insurers can post reviews and comments about Mutual of Omaha disability claims. Our attorneys respond to most comments posted by our visitors.
Mutual of Omaha was founded in 1909 as Mutual Benefit Health and Accident Association, in Omaha, Nebraska where it still headquartered. In 1963, Mutual of Omaha is widely associated with the wildlife television program, Mutual of Omaha’s Wild Kingdom, which ran from 1963 to 1988. The show was revitalized in 2002 with a new series on the cable television network Animal Planet. Mutual of Omaha recognized the importance of this program, as many of the people who grew up with the original series, still recognize the company as being associated with the program.
In 1926 Mutual Benefit Health & Accident Association founded its subsidiary, United Benefit Life Insurance Company. In 1941 the company founded its Group Insurance department. In 1962 Mutual Benefit Health & Accident Association changed its name to Mutual of Omaha Insurance Company. In 1981 United Benefit Life Insurance Company became United of Omaha. In 2006 Continuum Worldwide (formerly OISC) was created.
In 2007 Omaha Financial Holdings, Inc. was created as the parent company of Mutual of Omaha’s banking initiatives.
Mutual of Omaha has multiple subsidiaries including: United of Omaha Life Insurance Company, Companion Life Insurance Company, United World Life Insurance Company Mutual of Omaha Investor Services, Inc., Continuum Worldwide and Omaha Financial Holdings, Inc.
Mutual of Omaha’s products include life insurance, Medicare supplemental insurance, annuties, and retirement plans, long-term care insurance, health, accident and special coverages, investment products, disability insurance, dental insurance, voluntary/worksite insurance, and special markets products. In March, Mutual of Omaha reported 2008 consolidated net income of $47.0 million on total revenues of $4.07 billion.
As disability insurance attorneys, Dell & Schaefer have represented numerous clients with their long-term disability claims against Mutual of Omaha and its affiliated companies. Disability Attorneys Dell & Schaefer have provided and offer the following legal services for disability claimants that have a long-term disability insurance policy or disability income policy purchased from Mutual of Omaha:
- Application for long-term disability benefits with Mutual of Omaha
- Application for short-term disability benefits with Mutual of Omaha
- Monthly claim handling of Mutual of Omaha long-term disability insurance claims
- Appeal of a Mutual of Omaha denial of long-term disability benefits
- ERISA appeal of a Mutual of Omaha denial of long-term disability benefits
- Lawsuit against Mutual of Omaha for denial of long-term disability benefits
- Lump-sum buyout of a Mutual of Omaha long-term disability insurance policy
- Department of Insurance complaints against Mutual of Omaha for wrongful delay and denial of long-term disability benefits
I filled a claim for Short Term Disability through my work and I know for a fact that my HR manager sent the fax in around Nov. 11th. I was off work from Oct. 31 to Nov. 27 and I am on intermittent leave now, but when I called to see why I hadn’t received my money yet at the first of Dec. they said that they never received my fax. I know for a fact they got it. This is ridiculous and I have been reading about Mutual of Omaha disability insurance and how they give you the run around. I had better be receiving my disibility pay really soon, or I will have to proceed with further action and get an attorney. I don’t even have my claim number yet. I pay into this weekly at work and if I don’t get my check very soon, as I said before, I will take further action.
Misty,
We sorry to hear about the difficulties you are experiencing with Mutual of Omaha. If you need assistance then feel free to contact us. You’re doing the right thing by staying on top of them.
I have been 8 years trying to get a claim paid for my wife , who has Huntington’s Disease. I live in a state that does not require a license for a Home Care sitter. They have denied 4 sitters because Mutual of Omaha said they were not properly licensed. They require an Agency. So, I got the largest firm in the area, that is also multi-state. They denied this claim because they said the sitter was not doing the required things. My wife’s policy pays $172.00 per day for in home care. The Agency pays $6.50 to $8.50 per hour and has an administration charge of over 1/2 of her benefits. I would like to see that benefit going to more hours for my wife’s care. That is if they every start paying for anything.
For every 100k claims that Mutual Of Omaha has, they know how many will die this week. They don’t know who is going to die but they know HOW MANY ARE GOING TO DIE. That is statistics and their whole business is based on statistics. If they can deny a claim for 6 months, that makes that company a lot of money. If 6 years that is $595,680 for Nursing home or $297,840. for in home care. Some of their techniques, always communicate via phone, except to deny a claim. They will tell you one thing via phone and another when they have to write a letter. They use the same technique when communicating with a Home Care sitter. You get one statement over the pnone and another written.
I filed a short term disability claim with Mutual of Omaha. During the process their original form faxed to my doctors office to be filled out then, and other medical records requested, to be faxed back were claimed to not have been received by Mutual of Omaha. I requested my doctor’s office, multiple times, to re-fax the documents, still Mutual of Omaha claimed they were not received any of those multiple times, although my doctor’s office had fax confirmation forms showing the transmissions were successful for each & every time. Not until I was given an alternate fax number direct to a specialist, and witnessed my doctors office transmit the fax, were the faxes received. This process and their run around dragged out the review process to 47 days. My claim was then ultimately denied based on a second doctor’s evaluation & not my primary doctor’s findings and original reasons for my claim. Now I must appeal their decision, and I’m contemplating how much more run around and how long of time this process will be dragged out again!
Dave,
Short Term disability claim decisions are generally made within 7-10 days. You need to be very diligent and detailed in your appeal. Please watch our videos on ERISA APPEALS as they may give you some helpful information. You can also contact us for a free consultation to review your disability denial from Mutual of Omaha.
Well my Employer put me on short term disability through Mutual of Omaha on 3/28/12 and not knowing a thing about it, I went on it. Well, after calling them day after day and going through hell waiting and waiting and getting all my records sent to them, on May 23rd I finally heard from them that I was denied. I would not recommend this for anybody. They are just like all the companies, as long as money is going in their direction everything is OK, but the minute they have to give any out it’s good luck Charlie. You better be prepared financially to not see any money for 2 months.
Gordon,
Please keep in mind that their initial denial may be a scare tactic to force you to return to work. You have the right to file an Appeal and you may be required to do so in order to preserve your right to sue them. If you need to appeal, then it must be done timely or your claim could be barred. If you send us your denial letter we will review it and let you know if we can assist you.
I was diganosed with a stroke on 5/03/2012 and was hospitilized, then put in rehabilitation to learn how to walk and adapt. I was then sent to outpatient OT and PT until my insurance would not cover anymore visits. I started getting my weekly amount not counting the first week of my illness and then all of a sudden Mutual determined I needed to be evaluated again by a date they determined. Mind you, my doctor filled out their physicial form stateing I needed at least 3 to 6 months until I was to be evaluated again. I have not seen any money from Mutual in about a month. I have received papers to pay or quit in 3 days for my rent, my PGE is getting ready to be turned off, I can’t even pay my health insurance premium which covers my medication. Mutual could at least send me a check to cover the dates passed. I am not to stress, well can I sue them for that also?
I am to the point of tears and it seems that Mutual does not care if they destroy my life. Can someone help me, I feel as though they are trying to destroy me?
FLH,
Please contact us privately and we will try to do whatever we can to assist you.
My husband was diagnosed with MS in February/2012. He tried to work for a few weeks, but he became worse. He applied for short term disability after his neurologist said he needed to stay away from work. Mutual of Omaha responded fairly quick and started receiving his check. They (Mutual of Omaha) led us to believe that should he need to go on long term disability, the process should be seamless. He received his last short term check the first week of June/2012. Then this crazy nightmare began.
Giving us the run-around is an understatement. There were so many times they kept requesting more detailed records. The doctor was called many times and told us the requested records were sent to Mutual. Mutual would then say they did not receive the information. There has been two times after waiting for the insurance board to review, they came back and said that the medical records do not support a diagnosis of MS. My husband has been to four doctors, two very good neurologists among them, has had MRI’s, CAT scans, and numerous other tests. ALL of his doctors confirm MS is the diagnosis. Just yesterday, Mutual called and now says my husband must go get a third opinion from a doctor they pick and send him to. More waiting… My husband has not received a disability check from Mutual since June/2012. In the meantime, he applied for SSDI and has been accepted and approved. Believe me, that is a blessing!
I am so puzzled as to why Mutual approved his short term disability because of a diagnosis of MS, but now they are saying the records do not support MS as a diagnosis for him to receive long term disability. I want to know: does Mutual of Omaha know something we don’t? Has my husband been cured of MS and they forgot to tell us? How can some mysterious heads sitting in some office at some table determine the welfare of my husband’s life? We are so at the end of our rope. Is is time to get an attorney?
Marilyn and Terence Krebs
Marilyn,
Hiring an attorney is obviously optional, but you are trying to deal with a multi billion dollar insurance company that can afford to delay and possibly never pay your husband’s claim. Mutual of Omaha has the right to make decisions without ever having a doctor exam him. There are many things that can be done to make sure your husband is protecting his right to benefits. It would great if Mutual of Omaha had a cure for your husband and if they did I am sure you would give up his disability benefits. But let’s be honest, they don’t know more than your husband’s doctors and they are trying to build a strong claim in order to support a claim denial. Please contact us privately and we will discuss your husband’s claim options in detail.
I filed for my short term disability claim on May 14th. I am having awful back and leg pain and can not sit or stand for any time period. Since then I have had to make repeated phone calls to Mutual of Omaha and had my doctors send medical records and MRI results to them. I was denied. I was told their nurse didn’t feel enough was being done by my doctors (who has me out on state disability at least until January 1, 2013). Since went does a nurse override a doctor and my state disability office. I have appealed and was again denied and told in so many word that I could go to work. I will be call the state Insurance Commission on Monday and a lawyer after that to see what can be done. I also have had to continue paying for the insurance all this time.
I have received disability from Mutual of Omaha for the past nine years. I was a Financial Controller and loved my job. I didn’t plan on having to go on disability but had purchased the policy through my company just to protect my family. I have had autoimmune issues since I was in my teens and was diagnosed with Hashimoto’s Thyroiditis at 25 and had been on thyroid medication since then. I began having back pain when I was in my late twenties and then the pain became diffuse joint pain all over in my late thirties. I was diagnosed with glucose intolerance, fibromyalgia, chronic fatigue (insomnia), chronic paratosis (my parotid glands no longer worked and I had contant infection which is very painful. I was also diagnosed with degenerative disk disease and borderline diabetes. I was put on disability and had no problem for nine years. I lost one of my main doctors due to his sudden death a couple of years ago. Then Anthem increased my premiums to almost a $1,000 a month and I couldn’t continue to pay the price. I was finally able to purchase a new Preexisting Condition Insurance for a reasonable cost. I had to change many of my doctors and it about killed me. I went into diabetic ketoacidosis in November of 2011 and was within two hours of not making it when I got to the hospital. I found out I never had Type 2 diabetes but have Type 1. It can go along with my other autoimmune issues. When I lost my doctors, Mutual of Omaha decided to send me to have an Independent Evaluation. None of my doctors agreed with the IE but I was just notified that what my doctor feel really doesn’t matter. I found they had video taped me walking my 10lb dog across the street and going to the grocery store. I can’t do this several days of the month. They sent the video tape to one of my doctors and and the evaluation and I had not seen this doctor for eighteen months. I see his nurse practitioner and had asked if they were going to send anything to my physicians to please let me know prior to doing so. This doctor had to ask the nurse practitioner if I was even a patient. I had asked them if they were going to challenge my disability to send letters to all of my doctors, which they failed to do. They finally did after I asked them why they only sent it to the one doctor and they didn’t have a good response. The letter was inflammatory to me. It suggested that much of this was in my mind (the type 1 diabetes?). The doctor at Mutual of Omaha said that my symptoms reflected more of the type 2. This letter was sent to the doctor that discovered that I had type 1 that it was in my mind. They had told my other doctor that the pain was in my head and what is so sad is that after I found out that the first doctor sent out the letter, I saw him and he didn’t remember writing a letter. He examined me and told me I was disabled. Then called me back in and told me they had video taped me and this was a matter for court. I knew there couldn’t be much on the video because I can’t quite run a marathon or even step over a curb without it hurting. I have a copy of the one letter and will be requesting a copy of the other when I go to my appointment. What they are doing to me is dangerous – if my doctor’s don’t believe in me I won’t get the treatment I need. My glucose has been out of control and this has really had an effect on my health. Stress raises glucose, I have no appetite and it’s hard to get sugar under control when you can barely eat. I have never been as sick as I am at this point in my life and two days ago, I received a phone call stating that I would be receiving a letter that my benefits are now cut off. That under their standards I am no longer considered disabled and I can do light work. They clearly do not understand all of the work that goes into being a Financial Controller or the stress associated.
At this point, I have no idea how I will keep living. If I could work, I would have been back to work a long time ago making the money I should have been able to make. I’m single and I have to adult kids living with me. Both have minimum wage jobs while they are trying to go to school. They can’t afford my expenses. My medicine is over $2,000 a month without insurance. I am so frightened and I have always been able to take care of myself and my family. I was receiving quite a bit monthly because it was based on my pay rate as a controller but much of it was going to medical expense. I don’t see how they can do this to me or how I will live. I’m not sure if ERISA pertains to me because I was a key employee. I could not do FMLA and paid for my own plan. The company paid nothing. They had also listed me as an employee and sent me a W-2 so I had to fight the IRS (and won) but it dearly cost me in stress and insomnia. The IRS was trying to collect $40k in taxes that they thought I owed because the W-2’s were not labeled as non taxable sick pay. This has been very long and I’m dearly sorry but it takes a lot to explain. If you can help me, I will greatly appreciate it. I will call tomorrow and see what can be done.
Gae,
It sounds like you have been through a lot for 9 years and that Mutual of Omaha is trying to do whatever they can to stop paying your disability benefits. There are a lot of issues you have mentioned in your comment and we would like for you to contact us privately so that we can discuss your options. Your claim may be governed by ERISA, which will require us to take immediate action in order to comply with any time deadlines. If you have not recovered or improved physically, it seems that Mutual of Omaha has acted unreasonably by denying your benefits. We look forward to speaking with you.
On May 23, 2012, I gave notice to my employer that I would be resigning and would officially quit after consuming all 90 days of my accumulated personal leave and my boss concurred that I would go on leave until September 1, 2012 and my employment would be terminated at that time. On June 17, 2012, I fell off a horse and broke my back. I applied for short-term disability through my United of Omaha Life Insurance Policy. After an appeal, my claim was denied stating that I was no longer eligible as of May 23, 2012 because I was not actively employed and I must be able to prove that I worked a minimum of 30 hours per week to be considered actively employees. How is this possible? Omaha defines being “actively employed” to include “a regular paid holiday or day of vacation”. Since after May 23, 2012 I was considered on vacation using my personal leave, how can Omaha deny my claim? Any thoughts you could provide would be greatly appreciated.
Troy,
We have dealt with your issued before. Mutual of Omaha is making a technical argument that will really depend on the language of your policy and testimony of your employer. You should contact us privately to discuss your options as we will need to review your disability policy.
I have a son who needs health insurance, can I put him on under me he an adult? He’s not working right now, dealing with pains.
Joanna,
Any questions with respect to your ability to place your son on your health insurance plan would have to be directed to the insurance company, or in the alternative, if the insurance is being provided by an employer, your HR department to determine if he can be covered.
I have major depression, fibromyalgia, chronic fatigue disorder, chronic pain, insomnia and sleep apnea. I have been fighting them for over 2 years now, during which I lost my job. I now have an attorney for this. Seems to be a issue with them, they want you to pay your money which for 10 years I have, but they don’t want you to have any back when you didn’t ask for the problems you have!
I would encourage anyone who has problems with Mutual of Omaha or United of Omaha to immediately contact an attorney. I want to talk about a specific situation in which I have supporting documentation. I opted out of pre-approved offers of insurance and credit solicitations for life. I was quite surprised when I began receiving solicitations from United of Omaha. They were vague, had minimum disclosures, did not say how they got my information and they wanted my banking information so they could enroll me immediately. I found the mail-piece offensive and by way of a form 1500 applied for a prohibitory order against the sender and prohibitory order #2072101 was issued 2-14-1013 by the USPS which instructed the company to immediately remove and refrain from mailing anything to me. Mutual of Omaha persisted and a complaint was filed with the state insurance commission. Shirley Harrison, the insurance investigator asked United of Omaha to provide a copy of the USPS order #2072101 along with documentation. Guess what, even though the prohibitory order, a legal document that originates from US AG Eric Holder was sent via registered mail, the state insurance commission was told by Mutual of Omaha they did not have the order. Only one of two scenarios are possible. Either Mutual/United of Omaha lost an important legal document, or they lied. I have taken legal action against people I knew were lying before. When you have a situation like this and and you are dealing with someone you cannot trust, your best alternative is to retain an attorney who will file a suit, and depose them under Oath, Under criminal penalty of perjury. The truth usually comes out and once a lie is exposed, the rest of their case falls. An attorney is best to deal with people of questionable morals. Regardless of what you may think attorneys general deplore lying and the court certainly does.
I received a phone call on 7/26/2013 from an agent for Mutual of Omaha in response to my inquiry for supplemental medical insurance to cover that which isn’t paid by Medicare. The agent was on the phone with me for an hour and a half and during that time the agent was able to qualify both my wife and myself for the plan. I chose the F Plan and was given the monthly cost. The agent told me Mutual of Omaha is the best plan in the U.S. for supplemental medical insurance and wanted me to sign up on 7/26/2013 to lock in the price of the insurance which would begin on 9/1/2013. I told the agent I want to discuss this with my wife, who was sleeping at the time. I told the agent to phone me on Monday 7/29/2013 and I think she will phone me. After I got off the call with the agent on 7/26/2013, I went on the Internet to learn what complaints people have had with Mutual of Omaha for supplemental medical insurance. There are two complaints that stood out as being significant complaints. One complaint is after Mutual of Omaha signs one up for a plan that is locked in for one year at a set price, which is low and won’t rise until after the one year term. Once the year is up Mutual of Omaha raises the yearly premium and I’ve found some people had their premium raised by 400 percent. I kept reading the complaints and the second major complaint I found is Mutual of Omaha doesn’t pay the bills which are sent to them by the doctor and makes decisions not to pay overriding the medical care which was prescribed by a medical doctor by stating the procedure isn’t necessary. This hit me like a ton of bricks as I never expected a provider of medical insurance to make decisions as to what medical care is necessary for a patient when a doctor prescribed the medical care to treat the patient to cure disease, relieve pain and help prevent future disease and pain. When the agent phones me I will tell her I reviewed the complaints people have about Mutual of Omaha and I will not obtain a policy with Mutual of Omaha, even if they gave me the policy for free as I don’t want any hassles with the company I chose to handle my medical insurance. I will also tell her not to phone me or contact me by any method and not have any other agent or representative of Mutual of Omaha contact me. I find these types of complaints to be very disturbing from a company that has been in existence for over 104 years (Charter issued on March 5, 1909), as they should have learned by this time how to keep their policy holders and not cause them to have any reason to complain. Mutual of Omaha is one of the largest insurance companies in the U.S. I expect better service from an insurance company than that which Mutual of Omaha gives to its policy holders and so do others. I will never tell others to look into insurance of any kind with Mutual of Omaha because I don’t trust them. Trust in an insurance company means the company is giving the good service to its policy holders, and Mutual of Omaha has failed in this regard. This is too bad as were Mutual of Omaha to have always provided the best customer service they would have been the leader in all types of insurance many years ago. I do think the executives who run Mutual of Omaha aren’t aware of what is driving people away from buying insurance of any kind from them as the corporate atmosphere is one of greed and providing very large salaries and bonuses to the executives without thinking of those who have enabled them to earn their large salaries and bonuses. This my friends is corporate America and it is hurting people and I’m not going to be one of those to be hurt by them. I expect an attorney for Mutual of Omaha to either post a reply to my comment and/or contact me by email, and the attorney’s name may be Greg Dell or Stephen Jessup. I will check this site in the future to see if there is a response or if my comment wasn’t accepted for posting and if it isn’t accepted for posting I may chose to post my comment on other web sites for complaints against businesses and business practices. I never in my wildest dreams thought Mutual of Omaha would treat its policy holders without compassion and provide the best insurance for the money in the insurance industry. Marlin Perkins must be turning over in his grave (Moderator on Wild Kingdom) for he was a stand up kind of man who believed in Mutual of Omaha for they were tops in the insurance industry for many years and this type of treatment of policy holders would have been the reason for him stop endorsing Mutual of Omaha. I am not and have never been associated with any other insurance company other than purchasing insurance policies. I have never been employed by an insurance company. I am retired and have watched the rise and fall of businesses and the downfall of businesses is mostly due to greed and mismanagement. Thank you for reading my comment. I hope you will inform upper management of my comment and possibly they may do something to correct the mistakes made by corporate management of Mutual of Omaha and in the future provide the best service to its policy holders, which they have neglected to do for many years. Take care of the customer is the basic premise of managing a business and somewhere along the way management lost contact with the customer who is or may become a policy holder.
I’m a disabled vet and go to the VA for healthcare. On February 14, 2012 I had a massive heart attack and after rehab improved more then the doctors thought, so after about 9 mounts I tried to go back to my job as an auto mechanic. I tried this for 5 months but could not work more then 2 to 3 days a week constantly taking brakes and ending up in the ER about every two weeks. Since then my health has ben getting worse including a stroke in October 2012. Every time you go to the VA you get different doctors that don’t know you and have their opinion on test results. Since I’ve been to the VA more then I can count my records show some ups and downs. Your company has stopped my claim because of this up and down readings. I’ve had the doctors form filled out showing my limitations and was told your company does not believe a federally employed doctor and lied when she filled the form out and signed it (note the VA is also getting this information). I’m sure they will not be happy about that. I have been doing what you have asked for four months stressing me out, causing medical problems.
Glen,
I am uncertain if your issue is with a disability policy with Mutual of Omaha. If so please feel free to contact our office to determine how we may be able to assist you.
Mutual of Omaha is a rip off. When my husband died in 2011, they refused to pay his death benefit because they said he was disabled when I insured him. He retired from his job right after I took out the policy. He chose to retire, he was not forced into retirement. Three months later, I had a hip replacement. You guessed it… they declined to pay because the doctor had prescribed 800 mg of Ibuprofen for me to take for pain. I held onto the insurance thinking if I ever needed it they would be there. Wrong again… had surgery August 19th (rotator cuff),filed for disability after my employer was assured I was covered. Three weeks later after going through 3 other companies to try and find out the problem, I was told I did not have short term disability. I only had Long term disability because I never signed a paper (that I never received in the mail) to have my allotment increased to cover your rate hike. Really? When cable raise your rates, they send you a letter informing you and then they raise your rates. I did file a complaint with the Insurance Commission in N.C., but later I was informed I would have to file it with the state of Va. because that’s where your company’s headquarters has run to. I have no disability coverage for this surgery and my last paycheck was $2.22. Thanks, Mutual of Omaha… Your soon to be former customer.
Please hesitate & educate yourself when deciding on short term or long term disability insurance via Mutual Of Omaha. The company is very corrupt. They speak to you like you’ve been friends forever. They remind me of spiders that once you are hooked you and youre family are in serious financial and emotional torture that never ends. This also includes their life insurance! Just Please Be Aware…
I’ve been denied on my short term disability policy from through my employer. I’m currently awaiting an appeal. I thought when I got the denial phone call I requested an appeal. I didn’t understand her reply but thought she said she was sending a form. I’m out of options, bills have piled up. I’m thinking of getting a lawyer involved. Since the policy was through my employer I don’t have the contract/policy. Can or should I file for SSDI as well? My HR at work said there was a waiting period. I think the last day I worked was Oct. 31 2013. I’ve yet to get any payment.
Gary,
You can begin the process of applying for SSDI benefits if you do not believe you will be able to return to work. Please feel free to contact our office to discuss how we may be able to assist you with appealing the denial of your claim for STD benefits.
I signed up for a STD and LTD policy to protect myself. Well, I had major depression from losing my only brother and going through a divorce all at once. My doctor put me on a medical leave due to major depression. Yes, all the reviews are true. Mutual of Omaha delayed my paperwork process. They said they didn’t receive any record. After 30 days they still didn’t receive the records my Dr office had already faxed multiple times. Then all of a sudden I get a call stating the records were in reviews and it would take about 5 days. Then two days later I get another call and my claim was denied per their medical reviewer. At this point I feel completely upset for them wasting my time. I feel like I’ve been giving them my money for no apperwnt reason. Is there any way to file a class action law suit? I don’t know what to do at this point. I feel cheated.
Vanessa,
I am sorry to hear about all that you have been through. ERISA, the law that governs your disability policy, requires you file an administrative appeal of the denial of benefits before you can file a lawsuit. Please feel free to contact our office to discuss how we may be able to assist in appealing Mutual of Omaha’s denial.
I think there should be laws put in to place to cover the average Joe. This company is awful. They say so much they don’t even know what lies they have told. My husband has filed a ST claim on his feet. The doctor put him off and after Jeff with mutual started asking what therapy he was in and how long he would be off and exactly what he had. I looked up what the doctor diagnois was which apparently Jeff with Mutual only has delay or reject on his computer because we told him we looked it up and husband would have to stay off his feet anywhere from a month to six months or more just depended on the disease and when it would stop. Well he received disability checks for three weeks until a recheck at doctor and they stopped it before they received paper work or anything and doctor sent paper work stating that nothing had changed. This is one jacked up company or may be its us for being stupid enough to buy their product. Anyway husband goes tonight to have MIR done the doctor said he would send them all the proof they needed. So here he sits the doctor will not release him to go back to work so husband ask Jeff at mutual to send him a release to go back to work if he says he is well and he said he could not do that. I think the government should mandate that if these companies deny people their short and long term disability then they should be able to give them a release to go back to work and if condition worsens or they lose a foot as my husband is being told then they can sue the company and the employees that works for the company that acts like such a superior jerks like they are doctors. I mean someone should be held accountable they sure don’t offer premiums back that have been paid in for years and never used. We the consumer have to pay the premiums then be told our doctors are idiots and we are denied then we the poor consumer that paid for these policies have to hire attorneys and pay for them the short term should have to pay attorney fees and if we win they should have to pay us and our attorney a check of the same amount until we are off it. I bet that would stop this denial for no reason except to hope we go away and forget about it. Just upset the poor middle class man always has to pay no matter what!
Mr. Jessup,
My wife injured her back when she was 18 working for a nursing home and had two failed back surgeries in 1990. She persevered and worked through college to become a pediatric psychologist. In late 2002 her disabling condition forced her out of her career. Almost immediately, Social Security (SS) declared she was totally permanently disabled. Mutual of Omaha (MO) was her group disability plan and almost immediately they also declared her totally permanently disabled in 2003 without any evaluation. Through the next 10 years MO paid her their portion of her disability claim without hesitation. In 2012 SS “renewed” her disability without an IME. Then, suddenly, in the fall of 2013, MO decided she must undergo an Independent Medical Evaluation (IME). During the previous 10 years, she had undergone countless medical procedures and additional surgeries – with some resulting in serious medical related PTSD.
With my assistance, we have fought the request for this IME because of the following reasons:
1) MO is acting in bad faith by never requesting an initial IME and that by paying the claim for 10 years they were acting in bad faith by now demanding an IME;
2) because of her documented medical PTSD their request for an IME would further traumatize an already fragile patient and client; and
3) MO acted in bad faith when they did not respond to our well documented requests and demands from 2013 (more detail will help you here), and that their renewed pursuit of the IME in the fall of 2014 furthered their bad faith.
To date they are trying to work around our objections by gathering ALL of her medical records and by having private investigators spy on her.
Recently, I asked one of the MO managers how many clients were on MO roles with a claim longer than 10 years and he basically said not too many.
How can they do this to someone with a thoroughly documented 25-year injury? At this point they continue to pay her claim, but from my lengthy conversations with them, we can feel the axe coming. All of this is extremely well documented and I feel there may be a case here.
John,
Please note that most disability insurance policies give explicit right to an insurance company to have an insured undergo an Independent Medical Examination. Refusal to participate with same could result in a legally justifiable denial of benefits, so I would caution you strongly.
Have a torn rotator cuff and I need surgery. Will I have to have the surgery, in order to keep receiving payments? I really am frightened, I don’t want surgery, but if I do, who pays for the operation? Got hurt at work.
Mina,
I am not sure as to what type of benefits you are referring to: disability or worker’s compensation (as you indicated you were hurt at work). If your claim is for worker’s compensation you will need to consult with an attorney who specializes in those cases.
My husband has been on claim for disability insurance since July, 2008. He was found to be able to do sedentary work but had no transferrable skills in 8/2009 and benefits continued. Out of the blue in October, 2014 an request for another IME (after we have attended several) was requested, he complied and the IME doctor found agreed with his doctors restrictions. Mutual of Omaha got 3 addendums from the IME doctor who finally agreed he could do full-time sedentary work. I found out 1/29/2014, the claim was denied as of 1/26/2015 becuase he no longer meets definition of disability as he can do sedentary work and earn a gainful salary. Really? When he couldn’t in 2009, so after another 5 years of not working and not doing anything he has “gained” transferrable skills. When I asked for a copy of the denial letter I was told it wasn’t written yet. So they denied him before they sent him notification? How can you retroactively stop benefits before any decision? Howe can someone who has done nothing but heavy manual labor all of his life, not have transferrable skills and be gainfully employed in 2009, but can in 2015? When nothing has changed, in fact he has more issues now than he did, but they only took the original back complain into consideration. Their physician, Dr. Reeder actually commented there was no proof of original injury, amazing considering worker’s compensation settled for almost maximum benefit due to the work related injury that started this claim. I think what has been done is unethical and I will fight it as far as I need to go. The claim was originally denied at day 45, despite having a clinical review in the file that said he was disabled, but they ran out of time. After appeal, it was overturned. The entire handling of this claim from day one has been terrible and the file will reflect that!
Jerry,
You and your husband are certainly not alone in your dealings with Mutual of Omaha. Please feel free to contact our office to discuss how we may be able to assist your husband in appealing the denial of his benefits.
I was disabled in 2009 with a multitude of medical problems. I started a process with Mutual Of Omaha Disability. After months of jumping through hoops they finally decided to pay the claim. Shortly after I was awarded SSD. When that happended Mutual Of Omaha decided I need to repay their monies payed out on my claim to me. That money went to back bills accrued while waiting for the original disability claim to be payed. They attempted to strong arm with collection tactics but failed. They have kept my monthly payments to recover that money they felt was owed to them. They were calling it income supplement replacement and not disability. Well time passed and that account has been satisfied even by Mutual Of Omaha. Well they sent thier in-house collection agency to collect a month’s total payment that was missed at some undisclosed time and they were keeping the money. That was resolved and now they wrote directly to my physician and requested they fill out and return a form for my disability with diversionary statement that signed you agree with their created opionion of my condition whch would put me back to light duty work that does not exist. My doctor did a total reexamination, sent their appeal forms with her finding that I am not better and my disability is accurate and final. I won’t get better. They have called back after a week to let me know they recieved the appreal and it will be two weeks for their medical review staff to reach a conclusion. What’s next is anyone’s guess as they will line up the hoops I will have to jump through.
Jeff,
If Mutual of Omaha denies your appeal, please feel free to contact our office to discuss the next steps available to you.
I have been out of work since September 2014, did get my short term disability then, when it ran out in December, I applied for long term. Unable to work per doctor, have no income coming in and still not able to get my long term. I have sent in everything asked for and still no check. I have been let go since I can’t do the job no longer and have been with the company for 16 years and have had Mutual of Omaha from the start and have used it before and never had the trouble like now.
Evelyn,
Please feel free to contact our office to discuss your claim. Your carrier is certainly outside its 45 day window to render a decision.
My husband is going in for surgery on may 5th And he will be out of work for 1-2 weeks. He has paid time off/vacation through his work that he will be using. My question is: can he still claim std through Mutual of Omaha if he is getting paid his paid time off?
Heather,
He can still make a claim, but Mutual of Omaha’s policy would most likely allow them to offset any amount they would have to pay based on the amount received due to paid time off/vacation.
I recently filed a claim for disability and because it is just over a year that I have my policy. They claims that they will have to pull my doctor records again to make sure that I was not going to the doctor previously for the same medical condition. Now I looked at the attending Physician’s Supplement statement, they want the doctor SS# WTH and other employer I.D. Is this correct? I cannot believe these people. I will cancel this insurance as soon as I am well and back to work. It is not worth the hassle. I got this insurance so that when unfortunately situation occur like this one, I will not have to stress myself out to cover my bills.
Darlene,
The Physician’s Supplement statement usually requires your SS# and Employer ID. It is a way for the carrier to track forms. Pre-existing condition provisions are inserted into disability policies as a safeguard to prevent people from taking a job for the purpose of filing for disability coverage. If you were not fully covered under the policy for 12 months at the time you went out on disability, then it will trigger a pre-existing condition evaluation. If you had treatment (as defined in the provision) within the designated time frame before coverage then your claim could very well be denied due to a pre-existing condition. If your claim is denied on account of same please feel free to contact our office to determine if there is anything we can do to assist you.
I am trying to help a friend with a disability claim. What is the beginning date for short term disability?? He work his shift from 8:00 am on December 30 to 8:00 am on December 31. he then had back surgery. the company that he work for file the paper work with mutual of omaha. mutual of omaha states that since the new insurance company started on Jan 1 that they are not responsible. of course the new company is stating that mutual of omaha is responsible. where can i find any information or guidelines concerning this???
Kimberly,
The insurance company in effect as of December 30 (the last day worked I am assuming) should be responsible for payment of benefits.
Kimberly,
The insurance company in effect as of December 30 (the last day worked I am assuming) should be responsible for payment of benefits.
My husband was involved in car wreck on April of 2014 where he went to a chiropractor for neck and back injuries who then referred him to get MRI’s of his neck and back on August of 2014 where he then took his MRI’s to a specialist in September of 2015 whereas at this same time, September of 2014 my husband began working for a new company where he enrolled in short-term and long-term disability policy that went into effect on november 1, 2014. In the meantime, my husbands doctor gave him injections fur his neck and back in September of 2014 where he was fine and continued to work all the way up until July of 2015 when his doctor informed him that he would need neck surgery so he went on short-term disability in August of 2015, had his neck surgery on July 28, 2015 and continued to receive his short-term disability up until January of 2016. He has not been released from the doctor as he is scheduled for back surgery now in February of 2016 so Mutual of Omaha has begun the process of switching his short-term disability to long-term disability. My question is this…does his disability need to be converted to long-term disability when short-term disability consists of 3, 6, 12 & 24 months and we have only used 6 months and need only 6 more months in order for my husband to have his back surgery then he will be released to go back to work so why is Mutual of Omaha trying to switch his short-term disability to long-term disability when the whole benefit period for short-term disability has not been used up because short-term disability consists up to 24 months then thereafter the 24 months it is then switched to long-term? Is Mutual of Omaha trying to switch his disability to long-term in order to deny his claim by saying his disability is now pre-existing?
Cindy, I have not seen a short term disability policy that lasts for 24 months. The vast majority of STD policies cover up to 6 months of benefits and then it rolls into a LTD claim. The 24 month time frame you may have in mind usually applies to LTD benefits for one’s inability to perform the duties of their regular occupation. If the STD policy is in fact only 6 months of benefits then there does stand a very real possibility that the LTD claim would be subject to the pre-existing condition provision.
If I am approved for VA Disability compensation, will that amount be deducted from my short term payment amount?
Judy, most disability policies do not allow for the offset of VA Disability benefits, but you will need to refer to your policy and the section relates to “Sources of Other Income” or similar “Offset” provisions to determine how it will potentially affect your claim.
Hi I hope you can help me. I filed a STD claim with Mutual of Omaha in April 2016. I was hospitalized briefly and given MRI’s of my head, neck and vessels to rule out I had suffered a TIA or stroke, this was on March 16, and after my discharge from the hospital I called my PCP right away and was scheduled an appointment the next week to be assessed. During my appointment my doctor ordered that I have a few tests to rule out it was not my heart. I complied and also saw a behavioral therapist as recommended by my PCP because of the severe anxiety and stress that eventually was the cause for my brief hospitalization. All my cardiac exams came out normal. Of course I was happy to hear that and was told it was a warning sign for me to slow down and take care of me. Each week I saw my therapist, I am still seeing her and I have had nothing but misery working with the Claims analyst from Mutual of Omaha. I returned to work 41 days after being out, and finally received a check from Mutual of Omaha on May 24 for the time period after the elimination period ended from March 24-March 28. They still were requesting medical records, and 5 times I gave them the fax # to behavioral health for my records which they never requested. Here is the real kicker, I was told that the benefit payment is 60% of your weekly pay, divided by 7 days, but you are only paid for 5. So here I am thinking that I pay 100% of this coverage and instead of getting $585.00 per week I received $418.11 Is that correct are all companies that offer this insurance are they all based on 7 days? I am back to work but I am totally disgusted with Mutual of Omaha I am not renewing at open enrollment in July and I will keep on top of them. Any suggestions? Thanks for your help Diane
Diane, the actual benefit paid would be contingent on the language of the policy so we unfortunately would not be able to know if it is in fact correct. I do not know why they would still be requesting records though given the fact you have returned to work. Are they aware of this?
I was hired in May 2016 by Aethercomm Inc. in Carlsbad, CA paying from my paycheck for short and long term Mutual of Omaha disbaility by weekly.
On September 11 , 2016 I called sick and on September 14, 2016 my Dr. Boutros MD put me on disability. As a result of severe pain associated with neck, neurological and depression put me on disability with medication for 3 months whcih I disclosed to company early on the 15 sepetember 2016.
As a result shortly after in the afternoon of September 2016 my Director and Human resources called me and terminated my position as an excuse that suddenly with no review what so ever I did not meet what they expect and the position requirements has suddenly changed.
An employment attorney in Los Angeles Century City has taken my case for wrongful termiantion and act of descrimination representing me but they do not expertise or practice disability.
Meanwhile when I was terminated my benefits including short and long term disability with Mutual of Omaha was to be continued to September 30, 2016 and all costs was deducted from my final paycheck available.
I filed a claim with Mutual of Omaha for disability as my disability started before termiantion on 14 of September not pre-existing and Mutual of Omaha even was even getting paid till end of September with no regard for my disability sent me a cold letter that I am not entitled to any benefits because I was terminated on September 15, 2016 even though:
1. I was disabled before the termiantion
2. They were paid in full till end of September of 2016.
Can you help and repressent me and help recover anything against this seemingly unethical Insurance company.
Farokh, please contact our office to discuss your claim. If your conditions are not pre-existing then you certainly have a claim to be made.
I am about to change over to lt disability after 24 months. Does Mutual of Omaha offer buyouts?
Jimmy, Mutual of Omaha is not known for negotiating buyouts. If they do will typically require at a minimum that the insured to already be on SSDI and beyond the own occupation to any occupation period.
We have had life insurance with Mutual of Omaha since 1998 with a chronic illness rider that we decided to use in 2016. Our policy was for 500k, they approved us for 66,950.00 and made our face value 50k. So, that would leave us 383,050.00 to pull from if ever needed, or that would be left for the beneficiaries. Right?
Well, that is what someone would think. That is even what my agent thought as well as his regional manager. But after speaking to the home office employee that handles these transactions who also told me YES you can apply again whenever you need to, I did decide to apply again and was told that they keep the balance of 383,050 for themselves for us being able to take out the 66,950.00. They calculate this somehow with years of life expectantcy, etc. No way anyone could understand this, not even my lawyer. And no one offered to explain.
The letter I received showed me the #’s but sure did’nt tell me they kept the money. Very very misleading. They have agents out there selling this to innocent people that don’t even understand how it works, so they deceive their employees as well. Think about it, WHO IN THEIR RIGHT MIND WOULD GIVE UP 383,050 FOR 66,950.00. SCAM. AND THEY DO NOT CARE… STILL IN THE PROCESS OF FIGURING OUT WHAT I’M GOING TO DO. I HAV’NT EVEN TOLD MY FAMILY YET, THEY WILL BE DEVASTATED!
In October of this year, my primary physician put me off of work for 6 months because of acute anxiety, panic attacks and IBS that were prohibiting me from working. I am a teacher and had missed several days of work due to my anxiety. There were days when I had to run out of the classroom due to my IBS. My anxiety makes it difficult for me to leave the house and the IBS is so bad that I had to go to the ER for low potassium due to excessive diareaha. Overall, I am not in a mental state to be able to work in a classroom environment at this time. After receiving all of my doctor’s information regarding my mental state with detailed information about my health, M of O denied my claim, saying that I am able to work in my condition. They gave me the option to appeal, but what do I do? My husband became paralyzed from the waist down on Dec. 26th, further worsening my anxiety. Now we only receive disability through the state for my husband and are not making enough money to even pay rent. What do I do? My doctor offered to write an appeal letter on my behalf. What should it include? How can I get my disability claim approved?
Cam, if you are still within your 180 timeline to file an appeal it is imperative that you go through the appeal process. Please feel free to contact our office to discuss appealing your decision – you only get one chance at appealing the denial, so ensuring a full and complete appeal is crucial.
Working for only six months with the company that pays for Mutual Omaha disability insurance. I received the papers to file for STD after being placed on medical leave by my doctor and there is authorization to release medical and financial records forms. I do have the pre existing condition if they check more than 24 months medical records, so I expect a denial. Should I be able to restrict the release of medical records to under 24 months period? Is working comp a better alternative because Mutual Omaha may not pay a penny and appealing the denial may not get any other results because the right of refusal under pre existing condition not to mention my expenses are covered by my husband. In a non medical lawsuit these pre existing conditions also appliy?
Connie, although you could attempt to limit the medical records to be released to Mutual of Omaha, the likely outcome from the information provided would point to your claim being denied due to a pre-existing condition. If your disabling condition is a work related injury/condition then you could explore that option.
I have been on long term group disability and Social Security disability since 1989. I have been receiving a check for $285.47 from Mutual of Omaha. Can I get a lump sum check now that I am sixty three and permanently disabled?
Pam, Mutual of Omaha may be willing to negotiate a lump sum buyout of the remaining time on your policy, but there stands a likely chance that they will not pay you the full amount – rather a reduced number based on the present value of the claim. If that is the case it may not make sense for you to take a buyout.
My wife fell three years ago and broke her back. She has been found permanently disabled and receives Social Security Disability Benefits. She has also been receiving Benefits from Mutual of Omaha on a long term disability policy through her employer at the time of her fall. They are now saying that, based on their medical teams review, she can go back to work even though her doctors who treat her say she cannot. She is unable to set or stand for long periods of time, can only walk short distances, can not drive due to no feeling in her feet and legs from nerve damage. The doctors that she sees at Cleveland Clinic as well as her family doctor here at home in West Virginia state that she has reached her full maximum potential. We depend on this money to pay our household bills. We do not understand how a “medical review team” who have never laid eyes on her can say she is able to return to work when her doctors who see her on a regular basis have documented that she can not. Please help.
Dwight, please feel free to contact our office to discuss the denial of your wife’s claim. It is unfortunately all too common that an insurance company denies benefits based on a paper review of a claim.
I have tried and tried to get a lawyer thru this company. The guy they have to help me is on family leave and they won’t give me anybody else and like others they claimed they didnt get my papers for ltd in sept so I didn’t get disability until December. Some company no help at all don’t know how I will get social security disability without a lawyer.
Gretchen, we do not handle Social Security disability claims so I am not sure who you would be referring to, unless you are referring to your claims representative at Mutual of Omaha. If that is the case, you can contact our office and we may be able to get you in touch with a SSDI attorney our office has worked with.
Hi, I am receiving LTD from Mutual of Omaha. The policy was through my former employer (International SOS).
My question is am I able to work part time at a different job that is nothing like the one I was at when I was injured?
Russell, whether you can work part time in a different occupation depends on the specific language of the Group Policy. If you do not have a copy, you should request one from your employer and review. If you are unable to determine after reviewing you can contact our office and speak with one of the attorneys.
My long term disability policy states as follows:
Total disability means: you are unable to perform the material and substantial duties of your Regular Occupation and receive Regular Medical Care.
Regular Occupation: the occupation or occupations in which you are regularly engaged at the time you become disabled.
I bought this policy on my own (not through my employer) when I was working as an accountant for a big company. Few weeks ago, I started my own business (LLC. I am the owner/employee/manager/everything in this LLC. No more employees) as a boxing trainer, after resigning from my accountant job. I got injured. What is my “Regular Occupation”?
Rachel, the answer depends on when you became disabled. If you became injured after resigning from your accountant job then it sounds like your occupation would be considered boxing trainer. You should contact one of our attorneys to discuss your options and the best way to handle your claim.
I’m a heath care professional who treated severe trauma patients for 20 years. I developed PTSD and now I can’t even see trauma without having a major panic attack, even on meds. I had never had a single panic attack prior to getting PTSD. I’m published in the world’s most prestigious journals and text’s for my accomplishments. Mutual of Omaha is denying my second claim because I took Clonazapam for 13 years prior to developing full-blown PTSD. Now on many new meds and I let my license expire because I will never let myself be destroyed like this again in my profession. They said it is all preexisting because of anxiety. My doctors are all saying PTSD is, in no way, the same as general anxiety. However, Mutual of Omaha is saying my condition is preexisting. If it was, then how come I could perform my job and considered one of the best in the world by some trauma surgeons I worked with, but now I can barely drive across town? Can they get away with denying me for a condition that I’m not even limited because of. PTSD and anxiety are different conditions entirely. I’m 100% thinking of sewing as my doctor’s say I never had PTSD. Now I do and can’t work. Mutual of Omaha is denying my claim. My doctors insist my condition is new. Now what?
Doomed, if your claim has been denied then Mutual of Omaha will give you the right to appeal. Pre-existing condition limitations are typically defined very broadly and often difficult to get around. I encourage you to contact one of our attorneys to review your policy and denial letter and discuss your options.