Short-Term Disability Approval/Denial

[Yvette1026 0]

STD is usually an optional (i.e. additional cost) insurance to the employee. However, what you pay is based off of what your employers contracted rate is and it varies by company, amount of employees etc... Your rate will go up (if even by a few cents) every year, even if nobody in the entire company went out on STD, it's the cost of business. So the "You defrauding the company is making me spend more" argument isn't really valid.

Because whether you realize it or not, there's these people called actuaries who predetermine what the going rate will be whether an event happens or not. Even if nobody committed insurance fraud for 5 yrs, wouldn't matter, the actuary has already accounted and forecasted for it and your rate WILL go up, regardless.

I've done benefit administration (a wide title and term that includes various positions like claims examiner)on both sides for companies/HR and for the insurer and most recently *gasp* for Metlife.

I'm sure none of you took the time to speak with the poster privately as I did, to gain a better understanding before I posted anything.

This is one of those topics everyone will have their strong opinions on, but much like belly buttons, everyone has one.

My comment about MD had a precursor to it that said unless you can deal in or speak to the facts and truth of it, then your opinion isn't invalid unless you have Md next to your name. - But honestly even then, unless she's your patient it wouldn't matter.

So Flychica for example- working in insurance.. knowing what it's like to process the claim and rules, FACTS, etc.. Valid. Anyone else with like experience, valid. Even if found to be wrong, opinion is still valid because they're educated and experienced in it.

Everyone else, not so much. That's not discounting anyone as a person or their thoughts, etc... but it's all just a bunch of fluff.. when you cut through it all, what are you really saying? Are you educated on it? Or just making assumptions and forming opinions? Apologies if anyone was offended - that's not my intent. However, ganging up on the OP isn't exactly fair or nice of you either.

As you'll come to find about me, I speak on nothing unless I have something to truly add and contribute to a forum or conversation, and when I do speak I'm always certain that I can back up anything I say with facts, references, etc.. just how I operate.

[sndycnrd 1]

It is a shame that the edit button allows such extreme editing as what the OP did to this post. I read the original posts as they were being posted and what remains now is nothing, I mean nothing, like the original posts. They have been cleaned up immensely which now makes the subsequent posts appear heartless. The original post showed clear intent to defraud the STD insurance. She then used stereotypical hate to justify her fraudulent intent.

It now seems that the replies are out of proportion to the OP. Unfortunately, there is no way to judge one way or the other with what remains. :smile2:

Edited January 2, 2010 by sndycnrd

[flychica 0]

@flychica Sorry, my bad, I should have phrased that better. I did not mean to imply that you planned to call the insurance company, I was simply trying to express that I do not feel moved to do so.

So much ado, LOL.

Came back to add that this is why I dislike it when people delete posts -- you can erase a word from a page, but you cannot erase it from the memories of those who read it. Unfortunately, by choosing to delete a post, in effect, the poster is deleting any hard proof that she may have been misunderstood. Better to leave a regrettable post where it is, and then offer an apology, then to delete it, I think.

Peace, all!

LOL. Thats pretty much what she did...so even then reporting her to Metlife would be useless at this point because she realized what she put done was not good...if someone was to take it to them and deleted all of the bad stuff she put. Haha. No biggie to me though...

[flychica 0]

Please call it "short term" and not "STD". I have a filthy mind and every time I see "STD" I start laughing. :smile2:

Get your head out of the gutter...LOL. My hubby does the same thing when I say STD. Then asks what it means to make sure. Haha.

[flychica 0]

STD is usually an optional (i.e. additional cost) insurance to the employee. However, what you pay is based off of what your employers contracted rate is and it varies by company, amount of employees etc... Your rate will go up (if even by a few cents) every year, even if nobody in the entire company went out on STD, it's the cost of business. So the "You defrauding the company is making me spend more" argument isn't really valid.

Because whether you realize it or not, there's these people called actuaries who predetermine what the going rate will be whether an event happens or not. Even if nobody committed insurance fraud for 5 yrs, wouldn't matter, the actuary has already accounted and forecasted for it and your rate WILL go up, regardless.

I've done benefit administration (a wide title and term that includes various positions like claims examiner)on both sides for companies/HR and for the insurer and most recently *gasp* for Metlife.

I'm sure none of you took the time to speak with the poster privately as I did, to gain a better understanding before I posted anything.

This is one of those topics everyone will have their strong opinions on, but much like belly buttons, everyone has one.

My comment about MD had a precursor to it that said unless you can deal in or speak to the facts and truth of it, then your opinion isn't invalid unless you have Md next to your name. - But honestly even then, unless she's your patient it wouldn't matter.

So Flychica for example- working in insurance.. knowing what it's like to process the claim and rules, FACTS, etc.. Valid. Anyone else with like experience, valid. Even if found to be wrong, opinion is still valid because they're educated and experienced in it.

Everyone else, not so much. That's not discounting anyone as a person or their thoughts, etc... but it's all just a bunch of fluff.. when you cut through it all, what are you really saying? Are you educated on it? Or just making assumptions and forming opinions? Apologies if anyone was offended - that's not my intent. However, ganging up on the OP isn't exactly fair or nice of you either.

As you'll come to find about me, I speak on nothing unless I have something to truly add and contribute to a forum or conversation, and when I do speak I'm always certain that I can back up anything I say with facts, references, etc.. just how I operate.

I understand where your coming from, however I'm not sure if you even seen the original posts she has now deleted, that basically stated her intent of defrauding and pretty much how she could careless.

But in regards to the Actuaries...as someone who currently works LTC claims and works close to our Actuarial Department, yes...they use figures and such to decide what amount to set aside for the possibility.....fact remains, they are using the fact of inflation going up, but fraud from not only the provider and consumers is driving this figure up. So to say it doesn't on STD is not true. It does on all products for insurance and is a very valid argument considering she was basically blatant w/ stating she had intentions. So just because Actuarial had accounted for it 5 years ago...doesn't mean that it had zero affect on the premiums and rates.....that there proves it did.

The end, it still doesn't make it right and has eventually affected everyone in the long run. And I, like others who were on here in the beginning were not GANGING up on her. I come direct and thats all I others were doing. She was also the one coming at all of us talking about women with 7 children by 7 different daddies and stereotyping people....

Anywho......I'm done on this topic.

Edited January 2, 2010 by flychica

[zobee 0]

@ymjackson You made some very valid points, ym, but now I fear I have to weigh in on the other side --

The level or lack thereof of an education does not validate nor invalidate an opinion. For instance, ElfiePoo's opinion is every bit as valid as my own. One is not right and the other wrong, they are simply different.

Whereas someone such as yourself or flychica may currently work in insurance in some capacity, and whereas that experience might grant you a better knowledge of the ins and outs of the industry, it does not necessarily follow that your opinion is the only valid one on this thread.

It seems to me that this topic has touched a deeper nerve; it has brushed the moral Fiber of some posters in the wrong direction. Their opinions on the subject of the morality of the OPs actions are completely valid, apart from any education in insurance matters. If, in fact, the OP did state she was defrauding her insurance company (and I'll never know now, LOL), then there is evidence that her intended actions were less than honest -- and one does not require an education to have an opinion on honesty, wouldn't you agree?

I will agree, however, that forming such opinions without knowing the person or their true intent does smack loudly of being judgmental, but it is entirely possible that those who have flamed the OP have very good reasons to be judgmental (depending on the OPs original, deleted posts, as well as on the other poster's personal experiences, so on so forth...)

In short, I'm not going to judge anyone for judging others, LOL, because in essence, that would make me just as guilty of the very thing that I have endeavored to take a stand against.

@sndycnrd Agreed. Unfortunately, an enormous amount of energy has been expended on judging not only the OP in this thread, but several of the respondents, on both sides, lol. I'm not honestly sure what side I'm on anymore, ha ha!

@flychica No biggie to me, either, LOL -- like I said, I just find the emotional responses to this topic rather intriguing. I would love to understand them better.

Ah well, I think this topic is about dead, so I suppose I'll never know, lol. Good discussion, though! Peace to all :smile2:

[Cocoabean 430]

The OP posted in an open forum a question about disability coverage. One's right to respond should not have anything to do with working in the industry. Some people here might have had a need to use disabilty coverage and had approval for 6 weeks of covearge due to medical need from complications or some such.

This forum is designed for exchange of information and support.

The OP took it one step further to say her desire to be off work had nothing to do with medical need but hatred of the job. Again in an open forum.

Post in an open forum and you get what you get. She didn't ask for professional guidance from insurance folk nor for PM responses.

My opinion is just a valid as anyone elses.

[minimeme 1]

STD is usually an optional (i.e. additional cost) insurance to the employee. However, what you pay is based off of what your employers contracted rate is and it varies by company, amount of employees etc... Your rate will go up (if even by a few cents) every year, even if nobody in the entire company went out on STD, it's the cost of business. So the "You defrauding the company is making me spend more" argument isn't really valid.

This isnt even true. Jesus. And arent you the one who was telling everyone else how "invalid" their opinions were?

I know for a fact this isnt true because my STD has gone down due to low incidents. My current coverage costs me 11.96 per paycheck. Last year it was 15.92. Just looked it up cause I recall vividly getting an email telling us it was going down due to decreased claims.

And that doesnt even take into consideration companies who self pay insurance as mine does. They simply pay an insurance agency to process the claims they pay.

My LTD comes thru my union and it has gone down 4 years straight.

[ElfiePoo 109]

@ElfiePoo I choose to believe that you did not just infer that I am a dishonest person, simply because I do not choose to string someone up by their toes and set them afire, based solely on a handful of poorly thought out posts. Instead, I choose to wish you much peace.

@nobody in particular -- I find it interesting how much rancor this thread has stirred up and as a student of human nature, I cannot help but wonder why. Did I miss something? Did she flame someone or make some personally derogatory comments?

Zoebee,

No my comments about dishonesty were not aimed at you. Unfortunately, the poster has chosen to delete what she originally said...another indication that she understands the dishonest nature of what she intended...which makes it difficult to understand why there are such deep feelings on this issue.

Again, my comments were not aimed at you. :smile2:

.

[Yvette1026 0]

This isnt even true. Jesus. And arent you the one who was telling everyone else how "invalid" their opinions were?

I know for a fact this isnt true because my STD has gone down due to low incidents. My current coverage costs me 11.96 per paycheck. Last year it was 15.92. Just looked it up cause I recall vividly getting an email telling us it was going down due to decreased claims.

And that doesnt even take into consideration companies who self pay insurance as mine does. They simply pay an insurance agency to process the claims they pay.

My LTD comes thru my union and it has gone down 4 years straight.

Union coverage is VERY different from non-union coverage, the average worker is not union and does not have that same luxury.

Also your union more than likely "shops around" unlike most companies who stay with the same providers year after year and don't question contracts or increases. I can assure you that your situation is not the norm and most non-union people with insurance can attest that they have received increases and not decreases.

Someone else who works in insurance and with actuarial department, who sets the prices and increases (usually 5 yrs in advance) stated the same thing up above.

Enjoy your decreases and enjoy working in a union because it definitely has it's benefits! :smile2: