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Tara's complaint:
March 09, 2015

Insurance Company: Colonial Life & Accident Insurance Company
Coverage Type: Disability Insurance

  • PolicyHolder Service - Incompetent Employees
  • PolicyHolder Service - Delays/No Response
  • Claim Handling - Rude/Abusive Adjuster
  • Claim Handling - Unsatisfactory Settlement/Offer
  • Claim Handling - Denial of Claim

I signed up for short term disability (along with other services) with Colonial Life 11/2014 as a new employee. I have carried short term disability for the past 7 years. In the beginning of Jan 2015 I found out I had to have a hysterectomy ASAP. I have had issues revolving around this since I was 19 (now 40). I called the adjuster who gave me the initial information on the plan (because I do not understand the lawyer speak in the policy)in Nov. to make sure it would be covered, to make sure it would not be considered "pre-existing" (I figured because it had not been planned it would be covered, and to see if I could upgrade my plan. Lori, whom I spoke to informed me that I could not upgrade because it had not been a year, that if I upgraded the pay would just resort back to my original 60% coverage. I got off the phone with the understanding I would be covered at the 60%. I then called my doctor and scheduled surgery for 6 wks later. I filed all the proper paperwork and called to check on claim 1 wk later. I was informed that they needed additional information from my doctor re: pre-existing term. I again explained I had issues surrounding this area since 19. The gentleman I spoke to explained they just needed the information for their records. I had information sent. 2 1/2 wks after surgery I again called to check on claim, now expecting a check any day and was informed my claim had been denied due to pre-existing. I spoke to supervisor explained everything and was told she would call me back. I also called Lori whom I spoke to ahead of time. Her response was, "How was I supposed to know you hadn't had coverage for 12 mos" and, "you should have read your policy". I spoke with another supervisor who gave me more inaccurate data, saying I could have filled out a form proving previous coverage and they would cover it. She would re-open my claim. I was informed the next day that that information re:form ended in 2013, was inaccurate and I was once again denied. I am now going back to work 2 weeks earlier than I should due to having no coverage and no source of income. Had I been given the correct information ahead of time I could have put the surgery a little longer, worked overtime and saved money so I could take the full 6 weeks off of work.

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