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  • Report:  #147168

Complaint Review: UNICARE And Self Insured Companies - Atlanta Georgia

Reported By:
- Dubuque, Iowa,
Submitted:
Updated:

UNICARE And Self Insured Companies
P.O.Box 7423847 Atlanta, 31139 Georgia, U.S.A.
Phone:
800-232-0113
Web:
N/A
Categories:
Tell us has your experience with this business or person been good? What's this?
Unicare is a third party processor for self insured companies not just Ford but for me it is Whirlpool Corporation in Benton Harbor MI.

It appears that their regular mode of operation is to reject legitimate claims after a period of time. Not only myself but a co-worker who was on Long Term Disability received similar letters.

Here is how it works. You first get a letter telling you that you are covered under your Long Term Disability policy until you reach age 70. It specifically states that you meet all criteria to continue receiving benefits until you reach age 70 or no longer meet the criteria. Sounds fair enough doesn't it?

About 14 months after receiving this letter and receiving monthly benefits you receive a letter telling you that you NO LONGER meet the criteria even tho medically nothing has improved and some medical conditions have actually gotten worse. I guess they are aware of some miraculous cure that has taken place even tho you nor your medical provider are unaware of this miracle.

Now you call them and they claim they are "missing" some needed information to continue your benefits. Depending on who you talk to and what day you talk to them the "missing information they need" changes. They have no defense for why they did NOT give you the opportunity to provide the info before cutting off your benefits.

Next they tell you to file an appeal under ERISA. Yes you have this right and need to exercise it but DO NOT LISTEN TO ANYONE FROM UNICARE ABPUT THIS LAW OR PROCESS. They will try to tell you that you only need to fax them a piece of paper telling them you wish to appeal and all will be well. DO NOT DO THIS UNDER ANY CIRCUMSTANCES!!!!!!

A reading of the appeal process under ERISA will tell you that when you file your appeal you MUST INCLUDE everything you want to have as part of the appeal. If not and UNICARE decides to again deny your claim on appeal you must take your claim to Fedral Court. However when it goes to Federal Court yo CAN NOT add any additional information to your file so unless you have INCLUDED EVERYTHING the court will decide your case ONLY on what UNICARE supplies. I think anyone can see the folly in giving them this type of power over your lofe and your future.

While it is expensive, at this point you should get a lawyer involved to protect your rights. If you depend on UNICARE chances are you will lose benefits that are rightfully yours.

This is where I am in the process. I have hired an attorney but currently have no income to buy food or put a roof over my head. I think we all need to not only condemn UNICARE for their practices but the ERISA Act itself. Write your congressman and let them know that the law they believe is protecting us is actually hurting us.

Also be aware that the law changed in 2002. If you became disbled before Jan 1 2002 you only have 60 days to put your entire appeal together. If you became disabled on or after that date you have '180 days to do it.

Pam

Dubuque, Iowa
U.S.A.


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