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JHA Speakers: Share Data On 9-11-Related Mental Health Claims

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PONTE VEDRA BEACH, FLA. — An insurance group should support a project to find out how terrorist attacks, economic disasters and natural disasters affect the likelihood that U.S. residents with disability insurance will suffer from disabling mental health problems.

Dr. David Tolin, director of the Anxiety Disorders Center, Hartford, and Dr. David Lovejoy, behavioral health director at the Massachusetts Mutual Life Insurance Company, Springfield, Mass., made that recommendation here at a disability conference organized by JHA, Portland, Maine, a reinsurance and risk management arm of General Re Life Corp., Stamford, Conn.

Tolin and Lovejoy ran a breakout session at the conference on the effects of disastrous events on mental health-related disability claims.

Insurance industry employees suffered directly from the effects of a major man-made disaster just 8 years ago.

The Sept. 11, 2001, terrorist attacks on the World Trade Center in New York killed hundreds of employees of Marsh & McLennan Companies Inc., New York (NYSE:MMC(, and Aon Corp., Chicago (NYSE:AON), and 9 employees and 2 consultants at Empire Blue Cross Blue Shield, New York, which is now part of WellPoint Inc., Indianapolis (NYSE:WLP). The attacks also killed Neil Levin, a former New York state insurance superintendent, and they forced thousands of insurance carrier, insurance broker and benefits consulting firm employees to flee from offices in the Twin Towers.

But, even though the attacks disrupted the lives of thousands of insurance industry employees, as well as hundreds of thousands of disability plan insureds, insurers have been reluctant to release information about their own 9/11 “mental & nervous” claims because of competitive concerns and administrative concerns, Tolin and Lovejoy said during an interview.

Results of consumer surveys give some information about how mental health-related absenteeism and “presenteeism” change over time, but those survey results do not necessarily correlate with changes in disability claims, Tolin said.

Researchers have conducted studies on the psychological effects of traumatic events, such as waves of terrorist bombings, on the people in other countries, but those studies cannot necessarily help researchers predict how similar events would affect people in the United States, Lovejoy said.

Getting good information about the effects of traumatic events on U.S. work impairment is important, because “mass traumas are going to continue to happen,” Tolin said.
Insurance industry groups may be in the best position to help researchers persuade insurers to share mental & nervous claim data, Lovejoy said.

Also at the JHA conference:

- THE RISE OF EMPLOYEE-PAID PLANS: Christopher Jerome, a senior vice president at Unum Group Corp., Chattanooga, Tenn., and Robert Dignazio, an assistant vice president in the Wellesley Hill, Mass.-based U.S. operations of Sun Life Financial Inc., reported that traditional group disability insurers continue to seek opportunities to see employee-paid plans but continue to face cultural barriers.

The average amount of premiums per life tends to be smaller in the voluntary market, and employee consumers “really don’t understand the benefit,” Dignazio says.

When Sun Life worked with JHA to conduct a consumer survey, it found that many consumers view dental insurance and even vision insurance as being more important than LTD or short-term disability insurance, and that they are quick to drop LTD coverage when their expenses rise.

Researchers found, for example, that some consumers said they had dropped LTD coverage when they faced the expenses associated with buying a house – even though disabling illnesses and injuries cause many foreclosures.

Group disability insurers tend to pay level commissions, take a relatively low-touch approach to setting up plans and enrolling employees, and provide solid customer service once plans are in place, according to the panelists and audience members.

Audience members described a typical disability benefits broker as someone who plays a round of golf with a client and then makes a deal.

Historically, audience members said, worksite marketing companies have paid high up-front sales commissions, and used agents or enrollers who are at the worksite with donuts when the first employees arrive and stay until the last employees leave. But, in some cases, audience members said, the worksite companies have rigid computer systems that are hard to customize for large employers, and, in the past, they have tended to pay less attention to service once a plan was in place, audience members said.

An insurance company executives in the audience said he wished traditional benefits brokers were more interested in working with employees one-on-one.

“As their income stream from group health has been at risk, they haven’t changed anything,” the audience member said.

- HEALTH BILL EFFORTS: Several speakers talked about the possible effects of federal health bill efforts on the disability insurance community.

“What happens there has a huge impact on our business,” JHA President Drew King said during a general session.

Disability insurers deal with attending physicians and medical records day in and day out, and the major health bills could affect disability insurers by affecting privacy rules, claims systems, and access to health care, King said.

“How often are people going to be able to go to the doctor?” King asked. “Who’s going to pay for that?”

Later, during the breakout session on voluntary disability insurance, the panelists asked attendees about how they thought health bill efforts would affect them. Several said the kinds of health bills now being considered would hurt them, and a couple predicted it would help them. But most very intentionally sat on their hands.

One audience member in the session reported that most employers who offer traditional, employer-paid group LTD plans say they want to keep the plans. But, if major medical insurance prices continue to rise sharply, many of those employers say they will have to shift to employee-paid plans, the audience member said.

- METLIFE VS. GLENN: Norman Tolle, a partner at Rivkin Radler L.L.P., Uniondale, N.Y., talked about MetLife vs. Glenn, a 2008 U.S. Supreme Court ruling that focused on the possibility that a long-term disability insurance claim determination may have involved a conflict of interest,

On the surface, the ruling seems to focus mainly only the potential conflict involved when an LTD insurer is responsible for deciding whether LTD claims should be paid.

In practice, the ruling has a major effect on the scope of discovery, Tolle said in an interview.

“It puts a great burden on insurance companies,” Tolle said.

Now, Tolle said, instead of simply sending the court a claim file, an insurer may have to provide many other types of documents to respond to allegations of potential conflicts of interest.

- VENDORS: JHA attendees seem to be more cheerful this year than in March 2009, when the economy was just starting to come out of a state of freefall, and the exhibitors were busy answering questions from attendees.

GettingHired L.L.C., Bedminster, N.J., is persuading insurers to sign up for the FastTrackRTW program, a Web service that helps workers with disabilities find jobs, by providing support services and also by organizing a bulletin board for employers that are interested in advertising open positions to people with disabilities.

Claim Analytics Inc., Toronto, says it will be releasing its new return-to-work study, which will draw on responses from 12 insurers that account for about 70% of the disability market, in 6 weeks, and Reed Group L.L.C., Westminster, Colo., has come out with a new version of its MDGuidelines return-to-work guidelines. The new version does more to take socioeconomic factors into account.

FINEOS Corp., Cambridge, Mass., which bills itself as the 800-pound gorilla in the off-the-shelf disability claim system market, is talking about a major system it recently set up for Mutual of Omaha Insurance Company, Omaha, Neb.

ClaimVantage Inc., Portland, Maine, is offering a Web service that can help customers manage absences, short-term disability and long-term disability. Because ClaimVantage is distributing the service through the Web, using technology from Inc., San Francisco, it can get a line of business up and running in just 45 days, according to ClaimVantage Chief Executive Officer Leo Corcoran.

Companies that help disability insurers evaluate disability claims have some buzz because of new court cases, laws and regulations that are encouraging disability insurers to put more effort into getting outside perspectives on borderline claims.

Professional Disability Associates L.L.C., Portland, Maine, for example, can send claim reviewers into an insurer’s office. The claim reviewers can be truly objective, because their compensation has nothing to do with whether a claim is accepted or rejected, according to Douglas Palmer, a vice president at the firm.

BME Gateway Inc., Woburn, Mass., and MLS Group of Companies Inc., Southfield, Mich., are two other independent medical evaluation firms at the conference. MLS notes that it now has full, 3-year independent review organization accreditation from URAC, Washington.

Several exhibitors and sponsors – including Allsup Inc., Belleville, Ill.; Doherty Cella Keane & Associates L.L.P., Washington; GENEX Services Inc., Wayne, Pa.; Integrated Benefits Inc., Jefferson City, Mo.; and the Social Security Law Group L.L.P., Norwell, Mass.- were at the conference to market their ability to help people with disabilities get through the daunting Social Security Disability Insurance claim determination process.

Allsup also is developing a collection of services that will provide financial advice and other types of support for SSDI applicants. Allsup got the idea to create a formal support services program after the executives there realized that SSDI applicants already are asking the firm for advice about matters other than SSDI, says Ron Buerges, Allsup’s chief operating officer.

Private investigators at the conference include Claims Bureau USA Inc., Burlington, Mass., and Insight Services Group Inc., Danvers, Mass. Claims Bureaus is emphasizing the prep work it does to ensure that it gets the right surveillance footage, not simply some kind of video.

ISG is marketing its social media search services. The firm has about 150 accounts and passwords that it can use to get into the common areas of password-protected sites and services, and it can use its private investigators license to ask site administrators for permission to get into users’ private accounts, according to Raymond Therrien, an ISG vice president.


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