ComplaintsforStandard Insurance Company

• Initial Complaint

  03/29/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Standard Insurance states that it provides case management support and a claim decision after seven days of receiving documents. I was unable to work after being hospitalized on February 09, 2022 and initiated a *** claim. All documents were sent to Standard on February 17, 2022. On March 15, 2022 the *** analyst called to say that I had to file a new claim with waiting period beginning all over again (for the same claim), instead of filing the claim as new in the first place. I was forced to submit doctors statement and employers statement all over again, which was the exact same information because it was for the same incident on February 09th. Did not receive a new claim number until March 25, 2022, with the demand for duplicate paperwork after the claim number was created. Today is March 29, 2022 and all duplicate documents have been submitted. Have not received correspondence from Standard for case management or support or to confirm that any documents were received. I had to call them each time with them telling me to wait another week. The loss of income that is supposed to be replaced by this insurance has led to an eviction notice and me not being able to pay my bills or take care of my two toddlers. I have still not received a decision on my original February 09 hospitalization and subsequent illness. It has been one month and 20 days so far (almost 7 weeks) since my hospitalization, with no decision from Standard. My children and I am facing homelessness at this point. And my mental health has declined from the stress of not getting any answers or help from Standard Insurance.

  

  Business response

  04/05/2022

  Re:      ***************************************
  Policy ******************************************************************************* prior claim: 00HU8015
  Complaint No. 3009
  
  
  
  
  Dear ******************:
  
  We are writing regarding the above referenced Short Term Disability (STD) claim with Standard Insurance Company (The Standard).  This letter is being sent with regards to your request for additional information related to the complaint listed above.
  
  The claimant, **************************, voiced concerns about the amount of time The Standard took to review the information submitted. The documents had been initially submitted under Ms. ************ prior claim, 00HU8015. This claim, 00HU8015, closed on 1/18/2022 due to Ms.************ confirmed return to work date of 1/19/2022.  We apologize that the review was delayed while we set up the new claim and asked for duplicate information when this had already been provided. It does appear that we had updated medical information from 2/17/2022, office visit notes provided on 2/26/2022 and updated employer confirmation of the new cease work date provided on 3/10/2022. Once this information was obtained and reviewed it was concluded that a new claim needed to be set up because the employee had been back at work longer than the temporary recovery provision allows. We then moved to set up the new claim and that was when ************************** was subjected to a long wait for the new claim to get set up and reviewed.
  
  Enclosed with this letter you will find a copy of the Employer email noting the return-to-work date of 1/19/2022 and her new last day of work 0f 2/9/2022. Public *********************** (PEBB)Enrollment, The Group Policy, and the Denial letters sent to the employee
  
  The two provisions that impact our decision for Ms. ************ claims are the Temporary Recovery provision and the Definition of Member provision.
  
  For Ms. ************ prior claim (00HU8015) the employee had recovered for a period of 22 calendar days. The allowable period of recovery during the Maximum Benefit Period is a total of 14 days of recovery. Therefore, we set up a new claim.
  
  According to PEBB, the employee did not enroll for STD coverage as of 1/1/2022.Therefore, the employee did not meet the definition of member when they ceased work again on 2/9/2022.
  
  However,************************** does have active *** coverage and the file has been forwarded to our *** Department for review.
  
  Please offer our sincere apologies for the delay in setting up the second claim for **************************. This added an additional 15 Business days for the claim set up that could have been avoided. Once all information was obtained the decision on the claim was swift and was completed in 2 business days.
  
  Please contact me if you have any questions about this letter or Ms. ************ claim.
  
  Sincerely,
  
  
  *************************
  Manager, Disability Benefits
  ************
  ****************************************************
  
  Enclosure: Group Policy 442210-D
                    Employer Email/Statement
                    Public *********************** (PEBB) Enrollment
                    Denial Letter(s)
  
  
  
  
  

• Initial Complaint

  03/19/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  The hospital has employed this company to provide us for our paid family leave fulfillment for maternity and paternity leave. This company was supposed to start paying me with weekly checks starting on/around January 31st. I had my baby on Feb 2, and called to initiate payment on 2/3. They then believed that I was collecting disability, so they didnt send me money. I called again, confirmed I was not collecting disability and they said that now they didnt have my updated wages and needed my wages for the 8 weeks prior to my leave starting to send me money, when the paperwork requested that the wages be submitted 30 days prior to the anticipated start date of leave, so they had the wages then but wanted more paperwork, my examiner said once she got that information, she would send me out a check immediately. That was submitted by my employee health nurse on 2/16 with confirmation that the fax went through, and the company never called me. I called again at the end of February and they claimed they never got the information, although the employee health nurse sent over the confirmation as well to them. The information was resent at the beginning of March, and they said that it would take **** business days to review the new documentation, I asked to speak to my examiner because that wasnt what I was told, and they said she would call me by the end of the business day, she didnt call me for 2 more days. When she called, she said she approved a check and it would arrive in 3 business days. It did not. I callled again and was told even though my examiner said 3 days, it would take ****. It has been 10 now and I havent gotten paid. I have been on leave for almost 7 weeks and have been struggling to provide for my baby as they arent paying me, and giving me the run around.

  

  Business response

  03/30/2022

  This letter is being sent in response to the complaint filed by *********************************, regarding her New York Paid Family Leave (PFL) claim, with Standard Insurance Company.
  
  In her complaint ************************ voiced displeasure at the timeliness of her payments.  She reported she had not received a check at the time of her inquiries.
  
  Before we issued payment, we needed to confirm her up to date earnings and other information from her employer.  A request was sent to her employer on March 2 and received back the same day.  Her claim was subsequently processed and payments issued to her on March 9th.  She will be paid for her period of leave from February 2nd through April 27. 
  
  Please note, after the first check was issued, it was discovered we had mailed the check(s) to the wrong address.  We have subsequently voided these checks, re-issued them and have overnighted them to her.  She should be receiving all retroactive monies due to her this week.
  
  I appreciate the opportunity to respond to Ms. *********** concerns. However, if you feel I have failed to address any part of the complaint, or if you have any additional questions or concerns, please feel free to call me directly.  Barring any future correspondence or contact we will consider this complaint closed.
  
  Please contact me if you have any questions about this letter or Ms. *********** claim.
  
  Sincerely,
  
  *******************
  Manager, Disability Benefits
  ************************

• Initial Complaint

  02/04/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I had 6th surgery in 2 years and my third stomach surgery. The Standard was sent this paperwork on 12/18/2021. I called the day they received a couple of weeks after that and the day after my surgery and was told time after time I was all set. My HR rep reached out saying no claim was open because the Standard didn't do.anything with the paperwork. So now I am not being paid because some how they think it's acceptable to sit on paperwork and not doing anything.

• Initial Complaint

  02/01/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have filed a short-term disability claim with The Standard, which was paid until it was completed. I faxed paperwork to The Standard on 01-13-2022. I was told to wait **** business days; the 10th day was 01-28-2022. I repeatedly called within that timeframe to check on the status. I was told that the examiner was still checking on the claim each day I called. On 01-28-2022, I called to check on the situation and was told they had lost my claim and had not started it. They had no explanation for what happened and have not tried to rectify the situation. They have not supplied me with a claim number or had any personnel call me to come up with a solution. I have still called to check on the status and have been told to wait for them to call me back. I believe they have no intention to help me or give me my disability check.

  

  Business response

  02/09/2022

  Re:      *************************
  Policy No. 442210
  Policyholder The *************** by and through its Public Employees' Benefit Board
  BBB Complaint      16699006
  Claim No. 00HS5896
  
  
  Dear ******************:
  
  This letter is being sent in response to the complaint filed by *************************,regarding his Short Term ********** (STD) claim, with Standard Insurance Company (The Standard).
  
  In the complaint, ****************** voiced his grievance with us regarding the timeliness of our review and that the claim had been paid until it was completed and that we had lost his Short Term ********** (STD) claim. 
  
  When ****************** initiated a claim for STD Benefits on October 7, 2021, we obtained all the information needed to make an initial claim decision on November 5,2021. His claim was approved on November 12, 2021, benefits payable through December 1, 2021 with a Maximum Benefit Period of December 14, 2021. The medical supported that the employee would be out for a few more weeks with a follow up noted to be needed by a specialist.
  
  According to ****************** his concerns were specific to faxed paperwork that he sent to The Standard on January 13, 2022. The file supports that ****************** did send in an updated Medical Questionnaire on that date. The customer service agents that spoke with ****************** gave the employee an expected review timeline of **** business days, however, our reviews at times may exceed those expected timeframes.  
  
  The review for the claim extension for benefits payable beyond December 1, 2021,was not completed until January 28, 2022. This review completion occurred on the 12th business day, which is longer than what we would hope to provide for turnaround. The re-opening and extension approved the claim through the Maximum Benefit Period for STD benefits and the claim was then forwarded to the Long Term ********** ***** ********** for review because ****************** has *** coverage as well.
  
  There is no history of a claim being lost, as this claim was active in our system and had been approved, as noted above on November 5, 2021. 
  
  The employee spoke with a STD examiner working his claim on January 28, 2022, again on February 2, 2022, and most recently on February 4, 2022, regarding the transition to *** and that the claim will be set up and an *** Analyst will be reaching out to him for any additional information that they may need. The *** claim number: 00HY0048.
  
  We do sincerely apologize for any delays that ****************** experienced. Our goal is to make timely decisions whenever possible.
  
  Sincerely,
  
  
  Manager, ********** Benefits
  **************
  

  Customer response

  02/09/2022

   
  Complaint: 16699006
  
  I am rejecting this response because: The Standard lost my new claim which was turning my short term claim into a long term claim. I faxed the paperwork on January 13th and on January 28th I was told the claim was never started. As of February 9th it is still not completed. Therefore they have failed to deliver my Long term claim. 
  
  Sincerely,
  
  *************************

• Initial Complaint

  01/23/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have a Short-Term Disability Insurance Policy that I pay for through payroll deduction from my employer. The Insurance company is Standard. On December 10th,2021, I applied for Short Term Disability benefits because I am out of work due to surgery. I received two checks in January each in the amount of $533.75. I was then informed by Standard that since I qualify for **************** Disability, therefore, I owe Standard back pay of $912.04. I spoke with a representative from Standard 1/19/2022 and explained to her that I did apply for **************** Disability on January 5th, 2022, but I have not received an answer whether I will be awarded disability or not. The Representative I spoke to told me that, even though I have not been awarded **************** Disability, Standard will be requiring me to pay back $912.04 by withholding money from future payments to me regardless of my current status with State Disability. My complaint is that Standard should not be withholding any Disability payments from me until it is determined by the ******************* that I have or have not been awarded disability benefits.

  

  Business response

  02/01/2022

  This letter is being sent in response to the complaint filed by *****************, regarding his Short Term Disability (STD) claim, with Standard Insurance Company (The Standard).
  
  In the complaint, ************** voiced his grievance with us regarding the offset for the **************** Disability and the resulting overpayment on his Short Term Disability (STD) claim. 
  
  When **************** STD claim was approved, we supplied a letter that explained the weekly benefits and that Deductible Income, which is any other income that he may receive or is eligible to receive because of their disability or retirement would be considered. Furthermore, the letter explained that State Disability Benefits are considered Deductible Income. The information in their file shows that they are eligible for **************** Disability (SDI). This benefit is considered Deductible Income; therefore, we deducted an estimated weekly benefit of $570.02 per week.
  
   The actual amount will be updated when ************* supplies the award letter from **************** Disability.
  
  The ScriptPro LLC Group Policy Deductible Income provisions note that any amount you receive or are eligible to receive because of your disability under a state disability income benefit law or similar law are considered Deductible Income. Therefore, ************** would need to apply for the **************** Disability and supply The Standard the outcome of the application.
  
  From the most recent letter obtained from **************, he has requested a review of our decision to estimate and deduct the **************** Disability from his STD Benefit. We have a submitted this for review and ************** will be supplied a response from our separate review unit within 45 days.
  
  In the meantime, ************** can supply The Standard documentation of his pursuit of Deductible Income and or the award or decision notification from the **************** Disability.
  
  
  Sincerely,
  
  
  Manager, Disability Benefits
  **************

• Initial Complaint

  01/20/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have coverage through The Standard for short term and long term disability. I submitted a Short Term Disability claim on 12/13/2021, and turned in all completed paperwork requested of me on 12/28/2021. I called numerous times making sure everything was completed from both myself, my physician and my employer and was endured my claim would be handled within **** business days. My claim has been bouncing between short term and long term disability. I have called daily for updates, in which no one will provide for me. The call center tells me my claim is being escalated and then Ill have an adjuster call and tell me its now long term disability and they have no further information they can provide. I have asked to receive a call from a manager daily, and have yet to be contacted from anyone willing to assist. Im a new mother out on leave associated with childbirth. I have a mortgage to pay and the company has continually failed to provide me with answers or any timeline on when my claim will be completed resulting in severe undue stress. The Standard representatives have told me numerous times a claim takes **** business days to process. My claim has been bouncing around for nearly a month now and Ive received no updates on even the status.

  

  Business response

  01/27/2022

  January 25, 2022
  Better Business Bureau
  Attn:  Summer *******
  Engagement Disputes Consultant
  PO Box 711
  ******************
  
  Re:      *************************
  Policy No. 442210
  Policyholder The ***************** by and through its Public ************************
  BBB Complaint      16489126
  Claim No. 00HV5172, 00HP4634, 00HX3063
  
  
  Dear ******************:
  
  In the complaint, ******** voiced her grievance with us regarding the delays that she experienced while awaiting a decision on her Short Term Disability (***) claim. 
  
  The initial claim, 00HP4634,was approved for *** benefits on October 8, 2021, for disability that started on August 28, 2021, which was payable through October 7, 2021. ******** reached out to The Standard again on December 13, 2021, to initiate a new claim for a related but different condition. However, the employee had not yet returned to work after the conclusion of her first claim that ended on October 7, 2021. Due to the provisions in The *************** by and through its Public ************************ Group Policy, we must review if the employee continues to meet the provisions of the Policy and whether or not the request for a new claim would be appropriate or if the employee has experienced a period of temporary recovery or continues to meet the Definition of Disability.
  
  We determined that the employee had indeed not returned to work and therefore the temporary recovery provision would not be applicable,and the new claim would not be supported since the employee was not actively at work prior to initiating the new claim. This resulted in us needing to have the original claim reviewed to see if ongoing disability was supported between the date that the claim ended and the new claim was initiated.
  
  Timeline of events:
  
  00HP4634: Original claim opened and approved through 10/7/2021
  00HV5172: New claim initiated 12/13/2021
  00HV5172: Documentation to support new claim obtained 12/13/2021 (Employee and Employer Statement and 12/28/2021 (****** Attending Physician Statement)
  12/29/2021: Letter to the employee that we have begun our review of information sent to the employee
  12/29/2021: Employee called to confirm all paperwork had been submitted
  1/5/2022: Letter to employee informing them that we need additional information to support disability is being requested
  1/5/2022: Requesting to have The *************** by and through its Public ************************ confirm employee, Ms. ****** last day of work and if the employee was on an approved leave after 10/7/2021.
  1/10/2022: Employee called requesting a call back on status of claim
  1/11/2022: Examiner called back and left a voicemail noting that we had requested information from the employer regarding the dates between the last day of work and the new claim requested with first office visit on the ****** Attending Physician Statement, of 1/4/2022.
  1/11/2022 Employee called in again about the dates and requested another call back.
  1/11/2022 Employee supplied documentation related to her FMLA leave of absence
  1/12/2022 Employer sent timesheets to reflect time worked and confirm the dates for FMLA and OFLA
  1/13/2022: Examiner called employee and left voice mail to review treatment dates.
  1/13/2022: Letter sent to ******** from The Standard noting that we sought medical documentation to support the dates between 10/7/2021 and the initial date of treatment we have on file for the new period of disability which was 1/4/2022.
  1/13/2022: Employee called and said that yes, she had been treated prior to 1/4/2022, with earliest treatment date of 12/1/2021.
  1/13/2011: Employee called in again and noted that she had submitted all her leave of absence information.
  1/14/2022: Employee called in for claim status. Employee requested to speak with a specialist or manager.
  1/18/2022: Employee called and requested to speak to someone about her claim status.
  1/19/2022: Employee called and requested to speak to someone about her claim and the maximum benefit period for *** benefit was discussed.
  1/19/2022: Examiner returned call and explained that the claim had rolled to the ************** for review. Advised that the employee should hear from the *** Analyst soon.
  1/20/2022: Examiner returned call explaining in more detail that because the employee had not returned to work and that the employee had exceeded the *** maximum benefit period, that the claim would be reviewed by the *** Department. Confirmed with employee again that they had treated on 12/1/2021.
  
  Before we are able to re-open the *** claim and make a determination on the *** claim,we need to establish that the employee would have met the definition of disability and any other applicable provisions under The *************** by and through its Public ************************ Group Policy.
  
  I understand that the contact center has remarked on an expected 710-day period for review, however, claims may take longer to review if we do not have documentation that is sufficient to support ongoing review.In this case, we have been seeking documentation to support if the employee still met the definition of member under The *************** by and through its Public ************************ Group Policy and if she had an ongoing disability between the dates of 10/7/2021 and when the provider noted that the employee would need to be out again, which was documented as 1/4/2022.  The *** team will complete this review and make a claim decision as soon as possible.
  
  In addition, while a Specialist or Manager did not directly speak with ********, the calls were addressed as noted in the timeline above.
  
  I appreciate the opportunity to respond to Ms. ***** concerns. However, if you feel I have failed to address any part of the complaint, or if you have any additional questions or concerns, please feel free to call me directly.  Barring any future correspondence or contact we will consider this complaint closed.
  
  Please contact me if you have any questions about this letter or Ms. ***** claim.
  
  Sincerely,
  
  
  *************************
  Manager, Disability Benefits
  ************************

• Initial Complaint

  01/11/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I filed a claim with the standard insurance company because my mastocytosis and reticulum fibrosis became overwhelming and I could not work.and I confronted ***** **************************************, and ******************************* about this repeatedly about their desire to deny this claim and dragging their feet re review of information I got my union involved repeatedly.Instead of taking the word of the doctor the expert and contacting the doctor in a timely manner they waited 5 months (after the doctor retired) to evaluate the claim and denied it in part because of this stating they were unable to discuss it with him. They also committed fraud; I signed an authorization for them to contact my employer ******* school district. However they sent my signed release (*********************) of information to state of ***************** of education who according to **** from the *** came back no employee by this name. My cousin works there and her name is ********************************* which is much different than my name. According to my *************************** and the ************************ Aires from the standard insurance company fraudulently sent the release I signed as ********************* claiming It was signed by *********************************. Hawaii state teachers union and a rep from California state teachers union are also looking into this matter. They denied my claim based on the fact that *************************** is currently working in Hawaii. We have 2 *********************** 2 ***** Finlaysons and 2 ******* Finlaysons In our family We are NOT the same person: The resolution I would like is that ********************************* and ******************************* lose their license to practice because of their fraudulent actions of sending my release to the Hawaii doe falsely stating it was signed for *********************************: Lastly, I do work for ******* unified and am on a leave of absence. ******* verified that I was working 15 hours but my hours were reduced to 12,5 hours when I got seriously ill per my request for leave. They failed to look at this

  

  Business response

  01/14/2022

  Given the nature of the complaint,including questions regarding the specific allegations directed at individual employees of The Standard, this matter has been forwarded to our **************** for further evaluation regarding a response to the complaining party.  This means the conversation with the complaining party will be taken offline for the time being. 

  Customer response

  01/14/2022

   
  Complaint: 16452552
  
  I am rejecting this response because:the business used my name to obtain records for someone else and needs to rectify this matter immediately, return my money, and cite the employees who knowingly sent my name and signature to an employer of a completely different person. 
  
  Sincerely,
  
  *********************

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