Principal Group Review

     How sure are you that you have adequate insurance coverage in the event of a disabling accident or illness?  Don't wait until after you suffer a disabling accident or illness to educate yourself about STD and LTD policies and companies!

     Many companies offer their employees benefits packages that include health and dental coverage, LTD, STD, and additional life insurance at group or individual rates.  While the group rates on some of this coverage appears very affordable, and certainly has attractive rates, you should consider the downside of opting into these group rate policies BEFORE you may need to collect on one.

     Group rate policies are governed by a different set of laws than the policies you take out on an individual basis.  Group rate policies are all governed by ERISA Federal Law.  They are not governed by the insurance laws of the particular state you reside in.

     ERISA law has some very important loopholes that you should be aware of when you purchase a group rate policy for LTD.  Unscrupulous insurance companies can take advantage of these loopholes if they want to deny these types of claims.

     Unfortunately, when I first began working for my last employer, they only had one employee benefit option for LTD insurance.  It was through The Principal Financial Group.

     Not having much knowledge about insurance policies or companies, except for what I had learned from buying home and auto insurance coverage, and hoping to never become disabled in the first place, I bought into The Principal Financial Group LTD policy offered to me by my employer.

     After paying on this policy for many years, my company added on Aflac as another option in our benefits package!

     Feeling as though I already had adequate LTD coverage through my Principal Financial Group LTD policy, I only added on a 90 day, short-term disability policy, through Aflac.  What a mistake!  I should have swapped my LTD coverage to Aflac, as well!

     I'll tell you why.

     I filed a claim for disability benefits simultaneously with Aflac, The Principal Financial Group, and with the Social Security Administration.

     Aflac processed my STD claim in approx. 10 to 14 days from receiving my initial application by fax (not within 48 hours like they advertise).  But, although their claims processing wasn't as fast as they advertise, the check I received from Aflac came in a timely enough fashion to make me VERY happy.  And, it was VERY needed, and appreciated, at the time.  My Aflac monthly benefits didn't equal what my full take-home salary was (I knew it wouldn't be when I purchased their policy).  But, I could pay my basic bills, grocery shop, pay my doctor, etc., on the monthly benefit check I received from them.

     I have absolutely no complaint about Aflac, their customer service, or their web site (where I could keep abreast on their progress in processing my claim).  They were wonderful!  It took alot of stress off of me at a time when I really needed one less thing to worry about!

     Meanwhile, in comparison, there is NO comparison between the service I received from Aflac, and the hellish experience I had with my LTD carrier, The Principal Financial Group!

     From my first contact with the Principal Financial Group LTD Department, and the SENIOR Claims Representative assigned to me ("JS", as I'll refer to this monster in this review), I had nothing but problems!  "JS" talked "down" to me right from the beginning.  I had the misfortune of having to have an "initial telephone interview" with him when they received my claim for benefits.  "JS" even told me, on that first contact with him, that he didn't think I was disabled or would be approved for Social Security benefits!

     My claims rep., "JS", was frequently out of his office, for DAYS, (on "vacation is what the secretary always told me) when I called to check on the progress of my claim.  He did not return my calls; and, the Principal Finanacial Group website was never updated to reflect that I had ever even filed a claim for benefits in the first place!

     Long story short, I was denied LTD benefits by The Principal Finanacial Group.

     The written notification of my claim denial (which they have to provide according to ERISA law) came in the mail MANY weeks AFTER the ERISA law deadline had passed.  I actually received two notifications.  The first draft of my denial letter was so cryptic, and incomplete, that I assume someone may have reviewed it and decided it should be rewritten in a less nonsensical manner.  Both envelopes must have been backdated on the postage meter in thei LTD department office (which is located in Des Moines, Iowa).  Or, perhaps both evelopes were run through the meter on the same day, but not mailed promptly.  I don't know.  What I DO know is that every other letter I received in the mail from "JS" arrived in my mailbox within 2/3 days time from the postmark on the envelope.  My denial letters came 2 and 4 weeks after the letters had both been postmarked.  What's the deal with that?

     So, what was The Principal Financial Group's justification for denying my claim for LTD benefits?

     Their notification of denial letter(s) stated that my medical records reflected that I had received treatment for a headcold from a local walk-in medical clinic aproximately 2 weeks BEFORE I was permanently released from work by my primary doctor.

      O.K., yes, I was treated for a headcold at this local walk-in medical clinic, on that date, because I couldn't get into my usual doctor at the time.

   The letter(s) when on to say that while this walk-in physician had made a note regarding my having  disabling conditions, he didn't specifically state in the notes he wrote ON THAT SPECIFIC VISIT, that I was permanently disabled as of THAT PARTICULAR DAY.

      Why would he?  I wasn't even officially released from work yet by my primary physician.  And, I was only at the walk-in clinic to address the issue of my headcold.  Give me a break!

  The denial letter)s) went on to say that on the basis of this "ommission", on the part of the physician treating me for headcold sysmptoms, at this local walk-in medical clinic, "The Principal Financial Group has made the determination that you are not disabled.".  "Therefore", their denial notification letter(s) went on to state, "You are not eligible to collect LTD benefits on your Principal Financial Group LTD policy. ".

     "JS", the Principal Financial Group Senior Claims Representative assigned to my case, called me several days after I received his SECOND notification letter informing me of my denial.  "JS" stated that he had "just received" medical records (which, I was able to verify, had been faxed to him a month earlier) and he wanted to begin my ERISA Appeal Process immediately.  "JS" asked my for  verbal permission to open the envelope containing the medical records he said he had just received.  He said that as soon as I gave him my permission to open this envelope, the clock would start "ticking" on my appeal process (usually 6 weeks from start to finish, per ERISA law, unless the insurance company requests an extension).  I feel certain that this was just another trick up his slimey sleeve to make my denial for LTD benefits an open and shut case.

     And, I'll tell you why. 

     I had learned, through researching ERISA laws on the internet (Thank God for the internet and the wealth of information it contains!), that any documentation not added to my file during the initial claim, and the appeals process, cannot be introduced at a later date, after the appeal process is over.

     Without an attorney to review what is already in your claim file, and insert whatever medical documentation may be "missing" from it, a claimant can easily loose their appeal, and have no leg to stand on later in a court of law!

     Also, under ERISA law, if you can't prove that an insurance company has willfully processed your claim without "good faith", you cannot receive any damages for their refusing to pay, according to the terms of your LTD policy.  (As a general rule, I learned, an insurance company will never have to pay punative damages for pulling any stunt they can think of in an effort to deny paying you your rightful benefits.)

     Paying on claims obviously costs the insurance companies money that they may rather not pay you.  Therefore, you can easily see the motivation they may have to arbitrarily deny your claim for benefits.

     The good news is:  The Social Security Administration, which was provided with the same set of medical records that I provided to Aflac and The Principal Financial Group, thought my medical records were good enough to approve my claim for disability benefits on my FIRST/initial application to them!

     I was approved for Social Security Disability Benefits within 120 days of my initial claim to them.  Statistically, only 18% of claimants who apply for SSA, are approved on their first application.  I think that says alot for the merit of my claim.

     The bad news is:   I had to hire an attorney, specializing in the ERISA laws, to file my appeal for LTD benefits through The Principal Financial Group.

     I didn't HAVE to hire an attorney to file my appeal for LTD benefits with The Principal Financial Group.  But, I ask you, would YOU risk receiving the same level of care and service from Principal Group (in a "make it or break it" appeal) as I did, without hiring an attorney?

     I wouldn't advise it!  And, I wouldn't advise anyone to use The Principal Financial Group for ANY of their other insurance needs either.  Live and learn!

     The contigency fee for an ERISA attorney in my state is 50% of any back benefits owed to you by your LTD insurance company.  That means I had to give away MANY thousands of dollars in back benefits that I should have been collecting each month from The Principal Financial Group when I was flat on my back and out of work.  I wouldn't wish my experience with this company, and my claims rep., "JS", on a dog!  

     Insuranace companies who offer group LTD policies have virtually nothing to lose by denying, or delaying, your claim for LTD benefits.  They have everything to gain if you give up and go away.

     In conclusion, I would advise that you weigh all your options for LTD insurance very carefully before you choose a company and a policy!

     You work hard for your money.  Before you commit a portion of your paycheck each month to securing this type of coverage, you should familiarize yourself with the terms of the policy you want to purchase, and the company that (should) stand behind it.

     The friendly local face of that insrance agent who sold you your policy IS NOT the same person, or agency, that you will be dealing with if you ever have to make a claim.

 PS:  Yes, when I realized that "JS", my Principal Financial Group insurance LTD claims adjuster/representative, was being rude to me, and later became unavailable to answer any of my questions, I requested another person to work on processing my claim.

     I wrote a letter, that didn't work.  So, I sent an email requesting a change of claims representative.  That didn't work.  I got no response from the company at all.  Finally I called the company direct and was told there was no manager in that day but that the secretary would take my message and forward it on to the manager of the LTD claims processing department.

     I NEVER heard back from a manager or any other Principal Financial Group company representative, at all.  My requests were forwarded back to "JS", who finally did call me back.

     I came home from a doctor's appointment one day to find a particularly nasty phone message from "JS" on my answering machine.  He HISSED into the phone saying he had received my requests (to have someone else manage/process my claim for LTD benefits).  You couldn't miss the rage evident in his voice. 

     Long story short, he said that I wasn't going to be assigned to anyone else.  I already HAD a senior claims representative in The Principal Financial Group LTD claims department "helping" me, and that was HIM!

     I listened to his vile phone message and noted that his call came from the Des Moines Iowa office he worked in.  I was also surprised to see THE TIME that his call came into my house.  He called me WELL after 6 pm in the evening when I would have thought everyone who worked in that department would be gone home for the day.

     Since "JS" is out of his office so frequently during the workDAY (and week), perhaps he works late, (AT NIGHT) when he is there.

     I also wondered whether The Principal Financial Group HAS any other LTD claims representatives.  Maybe Mr. "JS", SENIOR Claims Representative, is the ONLY rep. this company has.

     In any case, I gave up at that point and decided not to call "JS" back.  I don't have masochistic tendencies.  Neither am I intimidated by a young quasi-professional who wants to earn a yearly bonus at my expense.

     Is this how you would want to be treated by your LTD insurance carrier if you suddenly found yourself flat on your back with a major disability?  No, obviously not.

     If you already have an insurance policy with this company, I'd seriously advise you to look into swapping to another insurer now.

     And, I'd buy an individual policy, not a group coverage policy.  You'll get MORE coverage for the few bucks extra you'll pay for an individual policy.  And your policy will be governed by state law, which is better.  You be less likely to be living off of your savings, and the good will of family, while many months go by without anything coming in to pay your bills with.  That's what the Principal Financial Group did to/for me.  Then again, if you want to be starved out, kicked around, and treated like a dog, keep your Principal Financial Group Insurance policy.  You get what you pay for!