Reliance Standard

I was receiving STD and LTD from Reliance Standard without a problem until they suddenly denied my benefits without warning.

Reviewed by A.M. on March 9th 2014   Verified Policyholder
I have two Workers’ Comp claims filed against my employer, my Work Comp files were denied from the beginning and now four years later we are still litigating them. My Dr. Took me off work right away and I have been off work for four ears now. I applied for STD through Matrix/Reliance Standard, I received my benefits no problem, then at I think the one year mark my file was sent over to a LTD adjuster. I was receiving LTD no problem. (other than when they issued it late or it got lost) The LTD adjuster wanted me to be seen by an IME, I was seen by the IME who issued a report stating I am unable to return to work. In March of 2013 I received a letter from my examiner that stated the IME concluded I was unable to return to any job I had training for or education for, therefore my disability is certified through April 16, 2041. (which would be when SS would kick in) When I received the letter I called the adjuster to ask about the date. I asked him if they meant to put April of 2014 in stead of 2041. My adjuster told me, no the date is correct. Now my file has been transferred to yet another adjuster who sent me a letter dated January 22, 2014 requesting all medical from July 2013 to present along with a Physician Statement and an activities of daily livinig questionnaire. The letter stated that she needed these documents no later than February 24, 2014. I sent in the activities of daily living questionnaire on February 4, 2014. When I went to my doctor appointment on February 20, 2014 I obtained the medical records my adjuster was requesting and had him fill out the Physician Statement. I mailed all to the adjuster which was received on February 25, 2014. I then recieved a letter from my adjuster dated FebruRy 24, 2014 stating my LTD is ending because they didn’t get all the documentation they requested. What is interesting is… The initial letter I received dated January 22, 2014 requesting the documentation didn’t say anything about my benefits ending if they don’t receive the information by February 24, 2014. Plus my checks normally issue on the 1st of the month so she would of only had five working days to review the information. I called the adjuster as soon as I received the termination letter took several tries an e-mail and a call to her supervisor to receive a call back. She now tells me that the medical deprtment has to review the medical information and they are behind by a month. What???? Aren’t they bound by some insurance code or some rules and regs that state you have to be properly notified that your benefits will end, and isn’t there a time frame they Re bound by once they get the information that they have to make a decision???? I need to pay my mortgage and she doesn’t seem to care. The ironic thing is I was a work comp adjuster for 14 year when I got injured on the job.
Reply
Sent on March 9th 2014 by Attorney Stephen Jessup

A.M., it is not at all uncommon for an insurance company to enter a denial without warning. Are they paying the benefit while they review the information you provided, or are they forcing you to go through a formal administrative appeal process?