STD and insurance story

PhillieG
PhillieG Member Posts: 4,866 Member
edited March 2014 in Colorectal Cancer #1
No, it's not sexually transmitted disease, it's short term disability. I opened a claim back in October 17th 2008 so I could use intermittent days off for the days I have treatment and not have to use up all my vacation time. So the claim would let me use about 35 days as needed to deal with chemo, appointments, side effects etc. I had done this one other time a few years ago and it went without a hitch. Again, this was October 17th 2008. I got a letter on Thursday saying that they reviewed my claim and they are not able to pay me after Feb 28th, 2009. Why the $%#* did they wait 6 $%#* months to FINALLY review the case and let me know this? I just sent a PDF copy to the powers that be who deal with this stuff where I work and asked them to handle it. Also, I wanted them to reassure me that I would NOT have to repay work for the days taken. Work did let me know that I am covered but they are trying to figure this one out too. I know if I got on the phone with them (UNUM) I would rip someone a new one. I am still likely to write them a letter to ask them why it took 6+ months to get back to me on this but I'm afraid it would take 2 years for a response.

Ah...you just gotta love the insurance companies.
-phil

Comments

  • Paula G.
    Paula G. Member Posts: 596
    #2
    STD
    I had to respond. Phil, we had a similar problem. John's STD does not allow him to just use a few days. He had to be off for 30 days before it kicked in. Then we got a huge check (well not huge) but more than we expected and were told we would get checks every two weeks. That never happened. Lucky to get one a month. When he went back to work they said we owed them money. It was a small amount but still. I have also had insurance claims that the place that we went to keeps billing the insurance wrong. I would call and thought it was cleared up and three months later would get another notice. This kept going on for over a year and when they finally got it right my insurance company said it had been over a year so they wouldn't pay. They also said that we did not have to pay either. Good thing you turned it over to the people that deal with it. I hope it works out in your favor. It can be a nightmare sometimes. I have always wondered why they demand there money right away but if you over pay them it takes six months to get it back. Good Luck!
  • Nana b
    Nana b Member Posts: 3,030 Member
    #3
    Just to clarify
    FMLA is what you use to take time off - you are entitled to 12 weeks of straight time off or intermittent so long as you worked for the company 12 months, worked 1250 hours the past year, the employer had more then 50 employees in a 75 miles radius. STD is your insurance that pays you, usually has as a 7 day waiting period to kick in, it will not usually pay benefits if you are only out for less then the waiting time on your policy. Mine paid while recouping from surgery bur it will not pay for my intermittent leave.

    Hope this helps...
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #4
    Nana b said:

    Just to clarify
    FMLA is what you use to take time off - you are entitled to 12 weeks of straight time off or intermittent so long as you worked for the company 12 months, worked 1250 hours the past year, the employer had more then 50 employees in a 75 miles radius. STD is your insurance that pays you, usually has as a 7 day waiting period to kick in, it will not usually pay benefits if you are only out for less then the waiting time on your policy. Mine paid while recouping from surgery bur it will not pay for my intermittent leave.

    Hope this helps...

    Complicated
    The first time they called it STD and this time they called it the FMLA. The first time it was A-OK, this time it's been a bunch of BS. I want to tell them FU, but that would not be polite even if the are a bunch of SOB's.


    What really gets me is why did it take them 6 months to tell me they were not going to pay me after Feb 28, 2009. My claim was started on October 17, 2008. I was assured by work that I will not have to pay any money back so that's not a worry. I have good benefits but there is something VERY rotten with health care in Denmark (and the USA)
    -phil
  • Paula G.
    Paula G. Member Posts: 596
    #5
    PhillieG said:

    Complicated
    The first time they called it STD and this time they called it the FMLA. The first time it was A-OK, this time it's been a bunch of BS. I want to tell them FU, but that would not be polite even if the are a bunch of SOB's.


    What really gets me is why did it take them 6 months to tell me they were not going to pay me after Feb 28, 2009. My claim was started on October 17, 2008. I was assured by work that I will not have to pay any money back so that's not a worry. I have good benefits but there is something VERY rotten with health care in Denmark (and the USA)
    -phil

    Very Complicated
    STD can work several differant ways. You do need to be off a certain amount of time before it kicks in. We were over paid a bit and had to pay that back. FMLA does require a company to have at least 50 employees that is my understanding. That is why we were not able to do that. My husband's work only employs 40 or less.
    It does sound like a bunch of BS to me Phil. It is rotten that it took six months to tell you this. Hope it all works out. There is alot wrong with health care. I hope we can some day have it straightened out. Everyone has to much of the pie and the little guys pay to much for it. At least that is the way I see it. I could go on for ever but I won't. Good luck to you Phil. It will work out and I hope in your favor.
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #6
    Paula G. said:

    Very Complicated
    STD can work several differant ways. You do need to be off a certain amount of time before it kicks in. We were over paid a bit and had to pay that back. FMLA does require a company to have at least 50 employees that is my understanding. That is why we were not able to do that. My husband's work only employs 40 or less.
    It does sound like a bunch of BS to me Phil. It is rotten that it took six months to tell you this. Hope it all works out. There is alot wrong with health care. I hope we can some day have it straightened out. Everyone has to much of the pie and the little guys pay to much for it. At least that is the way I see it. I could go on for ever but I won't. Good luck to you Phil. It will work out and I hope in your favor.

    Hi Paula
    Luckily, my company has a policy that augments the state one so it makes it more flexible as far as missing a certain percentage of work (20% per week by state rules). Since I now go for chemo every other month and the month I go it's every other week, I have a 6 week "break" where I do not get treatment. My company plan covers me. I used to get upset and worried but now I pass it all to someone else who takes care of it. I have enough to do besides talking with people no the phone who don't even know what coverage I have.

    I'm sorry you ran into problems with your husbands job and FMLA. Like we all don't have enough going on. You know?
  • Nana b
    Nana b Member Posts: 3,030 Member
    #7
    The run around stinks!
    Being in HR I make it a point to make employees my priority, always have, always will. Sorry you had to go through all crapola! Now more the ever, I understand what people using the benefits go through and the followup that we HR folks need to do.
  • Julie 44
    Julie 44 Member Posts: 476 Member
    #8
    Nana b said:

    The run around stinks!
    Being in HR I make it a point to make employees my priority, always have, always will. Sorry you had to go through all crapola! Now more the ever, I understand what people using the benefits go through and the followup that we HR folks need to do.

    Hey Phil
    When I went out of work I went out on full FMLA..Then when I was able to fuction on somedays I went on intermittion leave.All I ever had to do was fill out the paper work get it approved by the board (I work for a school)and that was all..I am sorry you have to go through all of this crap...Write a letter to whomever is in charge to have your questions answered so this way you can write what you want as many times as you want to than rewrite it the correct way..So noone will get upset...Also with the FMLA they have to save your job maybe not the exact job but they must have one similar as yours..Good luck ........JULIE
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #9
    Julie 44 said:

    Hey Phil
    When I went out of work I went out on full FMLA..Then when I was able to fuction on somedays I went on intermittion leave.All I ever had to do was fill out the paper work get it approved by the board (I work for a school)and that was all..I am sorry you have to go through all of this crap...Write a letter to whomever is in charge to have your questions answered so this way you can write what you want as many times as you want to than rewrite it the correct way..So noone will get upset...Also with the FMLA they have to save your job maybe not the exact job but they must have one similar as yours..Good luck ........JULIE

    Hi Julie,
    I can't afford to not work, I am the bread winner and the one with benefits so work I must. Work had been VERY good to me and have gone above and beyond what most places would have done. I am letting work handle this, I am not going to waste my time with "those people". I do not need the aggravation. The only letter I may write is to express my feelings about how inept they are over there.
    Thanks everyone for your support, I hope none of you get the old runaround from insurance and benefit organizations.

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