What You Need to Know
- Prudential has pandemic experience from the 1918 influenza outbreak.
- The company is now paying about $85 million in claims for every 100,000 in additional U.S. COVID-19 deaths.
- It also had to adapt to new federal group disability claim review regulations.
Prudential Financial Inc. was one of the life insurers that helped the United States keep going through the 1918 influenza pandemic. It struggled to keep its own employees healthy enough to pay life insurance customers’ death claims quickly.
Now, the Newark, New Jersey-based company is working to get customers through the deadliest outbreak of infectious disease that that has affected the United States since 1918. The company has estimated that it gets about $85 million in claims of all kinds for every 100,000 in additional U.S. COVID-19 deaths.
Evan Scarponi is one of the leaders in charge of Prudential’s effort to pay the claims.
Scarponi is the chief claims officer in Prudential’s group insurance division. He oversees claims-processing operations for U.S. absence management programs and group life insurance programs as well as for short-term disability insurance and long-term disability insurance plans.
He began working as a disability benefits specialist at Unum in 2002, after he graduated with bachelor’s degree from Northeastern University, and he then began studying for a master’s degree in business from the University of Southern Maine while he was still at Unum.
In 2004, Scarponi moved over to Prudential’s disability claims operation. Since then, he has held titles such as director, process management, and director, long-term disability claim operations before getting his current title, in August 2019. He now manages a team of 550, with most affiliated with offices in Portland, Maine; Roseland, New Jersey; and Scottsdale, Arizona.
This month, he has been participating in the latest Disability Insurance Awareness Month campaign by continuing to work to improve claim-handling processes.
Here are four trends Scarponi is seeing in the group disability claim field today, drawn from a recent interview.
1. The effects of major new federal claim review standards have been tolerable.
The Obama administration developed a major claim review standards update.
The new regulations require a disability plan to give a worker a complete explanation of any claim denials; give the claimant complete access to the claim file and other relevant documents; increase claim adjudicator independence requirements and speed up claimants’ ability to file lawsuits.
Some insurers and insurance industry groups predicted the new standards would lead to more lawsuits.
The Trump administration gave critics more time to file complaints but ended up letting the regulations take effect as written, in in April 2018.
So far, “things have gone very well,” Scarponi said. “We’ve fully coded all of those changes into our systems.”
Most of the new requirements were about giving claimants more information, and Prudential did that by adding details to existing reports, he said.