Standard Insurance Company

Complaint: [redacted]I am rejecting this response because: I spoke with Carla M[redacted] with Standard insurance today August 5, 2015 @ 2:45 pm regarding my claim [redacted]. Carla stated she received confirmation from my Dr. [redacted] office on Monday August 3, 2015. She said she requested visit notes of what me and my doctor talked about my per my visit. I spoke with [redacted] (nurse) [redacted] today August 5, 2015 @3:00 pm and she confirmed that Standard Insurance did not send them information and stated they did not speak with Carla M[redacted] w/ Standard on Monday August 3, 2015. [redacted] told me that it's against the law to give information of my medical records whiteout my consent. I do know that's true ( HIPPA). Only consent form I've submitted to Standard Insurance is for  [redacted] ( Mother & Guardianship) has my consent to receive information regarding my claim. 
I'm very upset with Standard Insurance with the game playing their doing. My health at this time is even more horrible due to the stress of back and forth with them. I feel like they're doing whatever possible to deny me my benefits and drop my claim and me from Standard Insurance. I pay them out of my income to cover me when I'm unable to work not my employer,I do. The treatment I'm receiving from Standard is " UNEXCEPTABLE"! I am hurt, mentally and physically exhausted from Standard Insurance. I"m lost of words at this time.  [redacted]

This letter is being sent in response to the complaint filed by [redacted] regarding hisShort Term Disability (STD) claim with Standard Insurance Company. We are in receipt ofyour letter dated July 22, 2016 in which Mr. [redacted] felt our prior letter did not resolvehis complaint.
In the most recent letter, Mr. [redacted] stated he submitted additional medicaldocumentation and has not received a response from us. Mr. [redacted] did submitadditional medical documentation to us on July 20, 2016. In his complaint, which wasreceived by us around Noon on July 22, 2016 Mr. [redacted] noted he had not received aresponse regarding the receipt of this new medical documentation. However, a responseacknowledging the receipt of the receipt was sent to him that morning at 7:16am. Thisresponse noted he still needed to request a review of our prior claim decision.
Mr. [redacted] also noted he had not received a copy of the medical information in his filevia fax and a complete copy of the claim file via overnight mail. However, Mr. [redacted]was previously informed in an email on July 18, 2016 that a copy ofthe medicaldocumentation could take up to 30 days to reach him. A copy of the medical documentationin his file was faxed to him the morning of July 22, 2016 and a complete of the claim filewas overnight mailed to him later that day.
In a conversation with us on July 25,2016 Mr. [redacted] acknowledged receipt of thisinformation and it was again communicated to him he needed to request a review of thedecision to close his claim. Mr. [redacted] did formally request a review of the decision onhis claim on July 27, 2016 and his file was forwarded to our Administrative Review Unit foran independent review.
Our Administrative Review Unit will conduct the independent review of his claim andrender their decision as to whether any further STD benefits are payable. They will advisehim of their determination once the review is completed and update him regularly until adecision is made.
While I understand Mr. [redacted] continues to disagree with our decision, as I statedpreviously in my letter of July 18, 2016, I feel this file was handled appropriately and withinour normal standards of performance. Mr. [redacted] has exercised his right under thepolicy to request an independent review of our decision. I appreciate the opportunity torespond to Mr. [redacted]'s concerns. However, if you feel I have failed to address any partof the complaint, or if you have any additional questions or concerns, please feel free to callme directly. Barring any future correspondence or contact we will consider this complaintclosed.
Please contact me if you have any questions about this letter or Mr. [redacted]'s claim.Sincerely,Cary G[redacted]Disability Benefits Manager(800) 368-2859 ext. [redacted]

Complaint: [redacted]
I am rejecting this response because:The company stated that there is an explanation of benefits attached to each payment. This is not true. The checks come and there is nothing listed other than the benefit amount. There is nothing on the EOB that says nothing is being withheld, it just says what your benefits are. Having filled out all the paperwork, including the W-4 I assumed taxes were being withheld. A formal complaint has also been filed with the IRS.  I have each and every statement I received and would be willing to scan and send if needed.As far as them saying they are working with me to resolve the issue; they have offered no help. In a letter dated 3/16/17 from Peter I[redacted] they apologized for the error and gave me a web site to make a payment plan with the IRS. I had spoken with Peter and was told that the matter would be taken to his supervisor, Nathan. Guess it never made it that far. Any option I gave to them to resolve the issue they have just said no, and apologized for the error, saying there is nothing they can do. An absolutely horrible company to work with.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

We are responding to the above-referenced complaint received on September 23,2016.
[redacted] has filed a complaint with your office expressing concern over the delay inprocessing spouse's life insurance claim.
In 2012, Ms. [redacted] was approved by The Standard to continue life insurance without...

premiumpayment while she remained totally disabled. At that time, she was approved for $89,000 BasicLife and $43,000 Additional Life Insurance. These amounts should be based on 2 times hersalary (Basic Life) and 1 times her salary (Additional Life) rounded up to the next one thousand.
Ms. [redacted] passed away on May 25,2016 and a life insurance claim was filed on June 2, 2016by [redacted]. Upon review of the claim, the Life Benefits Examiner discovered that theoriginal amount of coverage approved in 2012 may have been miscalculated and was attemptingto research the discrepancy. We have since determined that the amounts of coverage approved in2012 were indeed miscalculated and an additional $3,000 Basic Life and $2,000 Additional Lifeis owed for a total of $134,000. A check has been issued to [redacted] for $134,000 plus$3,431.14 in statutory interest. Mr. [redacted] should receive his check within 7 to 10 businessdays.
We sincerely apologize for the delay in processing Ms. [redacted]'s life insurance claim and for anyinconvenience this may have caused.We will consider this matter closed barring further communication from your office. Should youhave any additional questions, please don't hesitate to contact me directly.
Sincerely,
Loreena A[redacted]

Re: Case# [redacted] Complainant: [redacted]
Insured:  [redacted]
Group Name:  [redacted]
NAIC No:  [redacted]Dear Revdex.com: We are in receipt of your correspondence regarding the above captioned complaint. The...

inquiry has been sent to our Employee Benefits Division disability manager, who is now reviewing it and will respond. I appreciate your calling this matter to our attention. Please feel free to contact me if you need anything further.

The company still has failed to contact me in efforts to resolve this matter. My complaint remains unresolved. Complaint: [redacted]I am rejecting this response because:Sincerely,[redacted]

To Whom it May Concern:   Thank you for sharing with us [redacted]’s concern about the decision we made to apply an Extended Benefit Waiting Period on his claim. The policy purchased by Mr. [redacted]’s employer does have a provision designed to encourage people to enroll for benefits when they...

first become eligible. If one does not enroll within 31 days of becoming eligible, but rather enrolls at a later date, any claim for benefits incurred during the following 12 months are subject to an Extended Benefit Waiting Period (EBWP). This means, during the first year of insurance, people on claim must wait longer to receive benefits than they would if they had enrolled when they first became eligible. The event for which Mr. [redacted] is claiming insurance benefits occurred less than 12 months after his insurance became effective, therefore the EBWP applies. If he continues to meet all other provisions of the policy beyond the expiration of the EBWP, benefits may be payable after that date.   Finally, while we cannot comment on the specifics of what he was or was not told when he was hired (or when he enrolled), The Standard works closely with his employer to provide education about the benefits his employer offers through our company. This includes, but is not limited to, benefit fairs and periodic meetings with his employer’s HR staff.   We appreciate the opportunity to respond to Mr. [redacted]’s concerns. If you feel we have failed to address any part of his complaint, please feel free to contact me directly.   Sincerely, Rob C[redacted] | Manager, Disability Benefits Standard Insurance Company 19335 NW Tanasbourne Drive | Hillsboro, OR 97124 Phone 800.628.8600 ext. 7202 | 971.321.7202 | Fax 800.378.6053 [redacted]@standard.com | www.standard.com Tell us why here...

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. The payment has been received. Thank you. Sincerely, [redacted]

[redacted]Please see attached letter[redacted]
We are writing iu response to the complaint filed by [redacted] regarding her Short TermDisability (STD) claim with Standard Insurance Company (The Standard).As Ms. [redacted] indicates in her complaint materials, her STD claim was closed for a period oftime while we were reviewing her file with the assistance of a Medical Consultant, andrequesting additional documentation from her medical providers. On February 9, 2016 adecision was made to extend Ms. [redacted] claim, and a check for $2,866.69 was mailed to her thenext business day. Her claim is currently scheduled to remain open through February 14; 2016,at which time we will request additional information to determine if she remains eligible for STDBenefits.
Barring further communication from you or your office, we will assume we have adequatelyaddressed all issues in this complaint, and will consider the complaint closed. If you have anyadditional questions regarding the administration ofthis claim, please contact me at the numberindicated below.

Complaint: 12457400
I am rejecting this response because:1) They do not manage a retirement account by my employer. It's a former employer from 5 years ago.2) I have recorded conversations where The Standard staff have confirmed receipt of the spousal consent form.3) The website has been down intermittently for weeks. I have attempted to call and get the form through email and The Standard did supply it by email.4) Losing sensitive paperwork is a big deal. Trying to pretend like you didn't does not mean that this won't happen in the future. I suggest your company re-evaluates its business practices in order to be more professional. 
Sincerely,
[redacted]

[redacted]Please see attached response[redacted]
January 27, 2016 Revdex.com 1000 STATION DR STE 222 DUPONT WA 98327 ATTN: [redacted] RE: ID #: [redacted] COMPLAINT: [redacted] Dear Ms. [redacted]: Receipt of your January 21, 2016 correspondence regarding the...

formal complaint filed by [redacted] against The Standard is acknowledged. We are sorry to hear that [redacted] was concerned about a claim being filed under her name with our insurance company. At The Standard, we strive to provide excellent customer service to our customers. While we would very much like to respond to you directly regarding the mentioned claim, our records do not indicate an Authorization for Release of Protected Health Information has been received. In the absence of receiving the required HIPAA authorization, we are unable to communicate with your office directly. We will review the information submitted to us and will respond to the complaint directly in a timely manner. Sincerely, Sara H[redacted] Quality Control Section Enclosure: Authorization for Release of Protected Health Information

Dear Ms. [redacted]: I am writing to update you on the status of my review of the concerns raised by Ms. [redacted] in her complaint to your office. As I advised by correspondence of June 23, 2015, Ms. [redacted] claim is currently under independent review by our Administrative Review Unit. A copy of their most recent correspondence to Ms. [redacted] is enclosed. I will continue to keep you informed regarding the status of the Administrative Review Unit's review of her claim and will notify you of their findings once the review is complete. Should you have any questions or concerns in the interim, please do not hesitate to contact me at the telephone number or email address below. Sincerely,
 
[redacted]SUPPORTING DOCUMENTS REDACED BY Revdex.com[redacted]

Re: Case# [redacted] Complainant: Insured:
Group Name:
NAIC No: Dear Revdex.com: We are in receipt of your correspondence regarding the above captioned complaint. The inquiry has been sent to our Employee Benefits Division disability manager, who is now reviewing it and will...

respond. I appreciate your calling this matter to our attention. Please feel free to contact me if you need anything further.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.
Sincerely,
[redacted]

Acknowledgment letter
We are in receipt of your correspondence regarding the above captionedcomplaint. The inquiry has been sent to our Employee Benefits Division disabilitymanager, who is now reviewing it and will respond.
I appreciate your calling this matter to our attention. Please feel free...

to contact me ifyou need anything further.

Re: Revdex.com ID N0.:[redacted] Complainant:      [redacted]
Insured:              same as above
NAIC No:            [redacted]Dear Ms. [redacted]: We are in...

receipt of your correspondence regarding the above captioned complaint. The inquiry has been sent to our Employee Benefits Division disability manager, who is now reviewing it and will respond. I appreciate your calling this matter to our attention. Please feel free to contact me if you need anything further. Sincerely,

November 20,2017RE: Complaint ID: [redacted]Complainant: [redacted]Insured: Same as aboveClaim#: [redacted]Group Name: [redacted]NAICNo: [redacted]To Whom It May Concern:The Standard Benefit AdministratorsThis letter is in response to the November 18, 2017 complaint from [redacted]. The...

GroupLong Term Disability (LTD) Policy under which [redacted] is covered was issued by TheStandard Benefit Administrators on behalf of Standard Insurance Company (The Standard). Thepolicyholder is the [redacted] and the policy is sitused in the state of [redacted]. [redacted] was covered under this policy as an employee of the [redacted].[redacted] filed a complaint regarding the denial of her LTD claim. [redacted] ceased work onMarch I 0, 2017 due to chronic severe pain in her neck, shoulders and back as well as chronicdepression. A review of her file, including but not limited to her medical records, concluded thatshe is not disabled as defined by the [redacted] Group Policy. Therefore, her LTDclaim was denied.We explained the denial decision to her in a letter dated October 4, 2017. This letter explained,in part, the following:"In conclusion, the available medical and vocational documentation on file at this time supportsthat you are capable of returning to work in your Own Occupation. We have completed the OwnOccupation review of your claim and have determined you are able to perform duties of youOwn Occupation. As such, we have determined that you do not meet the Definition of Disabilityfor Own Occupation. The [redacted] Group LTD policy has a Benefit WaitingPeriod of the longer of90 days or when sick leave ends. The Benefit Waiting Period means theperiod you must be continuously disabled before LTD Benefits become payable. No LTDBenefits are payable for the Benefit Waiting Period. The 90 day Benefit Waiting Period ends onJune 08, 2017. Medical evidence does not support disability through the Benefit Waiting Periodand ongoing. Since you have the capacity to perform your own occupation, you do not meet theGroup Policy's Own Occupation Definition of Disability and your claim is denied."This letter also explained [redacted]'s right to a review of our decision as follows:"If you want us to review this claim and this decision you must send us a written request within180 days after you receive this letter. If you request a review, you will have the right to submitadditional information in connection with this claim. Additional information which would behelpful to submit would be medical evidence which supports that your condition causessymptoms of such a severity as to preclude you from working in your Own Occupation. Pleaseinclude any such new information along with your request for review.If you request a review, it will be conducted by an individual who was not involved in theoriginal decision. If necessary, the person conducting the review will consult with a medicalprofessional with regard to this claim. The medical professional will be someone who was notpreviously consulted in connection with this claim. The review would be completed within 45days after we receive your request unless circumstances beyond our control require an extensionof an additional 45 days.We want you to know that upon further investigation, other valid reasons for limiting or denyingthis claim, which have not been previous! y considered, could come to our attention. Therefore,The Standard reserves the right to consider and assert other reasons for limitation or denial ofthis claim should they occur in the future."To date, we have not received a request for review from [redacted]. Please let us know if youwould like us to provide you with any additional information regarding this claim. Should youhave any questions regarding this letter or [redacted]'s claim, please contact me at 1-800-426-4332 X [redacted].Sincerely,Nicole S[redacted]Manager, Disability BenefitsThe Standard Benefit Administrators1-800-426-4332, ext. [redacted]