Date: Thu, 24 Sep 1998 05:53:29 -0400
From: judy morris 
Subject: New story for the Indictment -
         Another brave soul steps forward with his story

You have my full permission to put my story on your web site. I have no
fear of letting you use my name. I am the sort of person who tries to be
a "nice guy" when it is possible, but I stop being nice when people
attempt intimidation tactics on me. I have referred my case to my
Robert Lessman, (ASQ) CQA #16411     lessman AT bpr9000 DOT com
BPR 9000 Incorporated                http://www.bpr9000.com/
2086 Walsh Avenue, Suite C           408-727-2636 Voice
Santa Clara, CA 95050                408-988-1197 FAX only

If I can play an active role in your fight, please let me know. You can
review my on-line resume at:

Through the American Society for Quality (ASQ), I have a credential as a
Certified Quality Auditor (CQA). My primary expertise is in assisting
companies with compliance to quality management standards for the high
tech industry, including the ISO 9000 series and FDA "Good Practice"
standards. In limited situations, I would be a valid expert witness. If
UNUM was my client, I would advise them to provide substantially better
training to their claims reviewers and live up to their sales pitch of
offering a single point of contact for coordinating short-term and
long-term coverages. I would advise them to establish procedures for
handling correspondence by FAX, so it does not get lost so often. 

In my dealings with UNUM, I get the impression (professionally) that
people are just out of control and not properly trained to do their jobs
well. They view the employers as their "customers" and seem to believe
"cost containment" by any means will serve their customer base.
Claimants do not count. In a purely practical business sense, they are
way off base. Employers usually want employees to be served so well by
their benefits package that those benefits will build morale and
loyalty. When UNUM's behavior causes employee morale problems and
resentment against the employer, then they are not serving anyone well.
Robert Lessman, (ASQ) CQA #16411

>  Subject: UNUM
>  Date: Fri, 18 Sep 1998 06:09:49 -0400
>  From: judy morris 
>  To: lessman@bpr9000
>  Could you please send me a brief synopsis of your situation.

In January of this year (1998), my general practitioner (Dr. Epsein)
felt my "flu bug" was lasting too long and suspected I might have a
mycoplasma infection. He placed me on a high dosage of doxycycline. In
March, my health insurance finally approved an antibody test to confirm
the diagnosis of a serious mycoplasma infection. Even after a full month
on doxycycline, this tests indicated an active mycoplasma infection. Dr.
Epstein told me that the prognosis was "dismal," so I asked for a second
opinion from a specialist approved by my health insurance. This
specialist agreed with Dr. Epstein in May. 

I still had trouble accepting such a dire diagnosis, so I went to a
specialist outside my insurance network in June (Dr. John Wakefield).
Dr. Wakefield had a 100 percent cure rate for mycoplasma infections
through a protocol that required being on high doses of antibiotics for
six weeks at a time, then two to four weeks off the antibiotics to allow
meaningful testing. In most cases three cycles (six months) of this kind
would totally knock out the mycoplasma infection. In rare cases, it
would take up to six cycles (one year) to get life back to normal. 

>From January through the end of May, I struggled to continue working.
Dr. Wakefield convinced me that I would be totally disabled while I was
on this treatment regimen, so I applied for California State Disability,
UNUM's short-term disability and UNUM's long-term disability. 

With the support of my general practitioner and two specialists, the
State of California expedited my claim effective June 1, 1998. The state
checks started to come regularly by August, but they barely pay for rent
and some food. 

UNUM's short-term disability and UNUM's long-term disability divisions
do not talk to each other. Each one keeps pestering my doctors and
myself for the same information over and over again. This is significant
because UNUM's sales pitch to employers says they have a single point of
contact for all disability claims. That sales pitch is a flagrant lie. 

Both my point of contact for UNUM short term disability and my point of
contact for UNUM long term disability repeatedly encouraged me to send
information by FAX to expedite matters, but they have repeatedly "lost"
anything that I would FAX to them. I have started to send everything by
certified mail, so I at least I have proof that someone at UNUM received
the information. 

One of their requests for "supplemental" information asked for
information about my health insurance carriers and demanded print-outs
of all my prescription drugs for the past two years. I did not
understand why they needed this information and strongly felt it was
just one more of their delaying tactics. I called my contact at UNUM
long term disability for an explaination. She would only say it was a
standard form at UNUM and I had to complete it. A few days later, I
received a threatening letter from UNUM informing me that they could
cancel my claim and void my policy if I failed to fully cooperate with
their demands for information.

My employer fully supports my efforts to get UNUM to perform on their
commitments and plans to find another carrier next year. The benefits
manager at my company says UNUM's customer service has been bad for a
lot of people, not just me. 

On one occation, my usual points of contact were not available and I had
to talk with someone else. This reviewer told me that UNUM routinely
ueses the "pre-existing conditions clause" to deny all claims by people
who have seen a medical doctor in the six months prior to receiving
their policy. She seemed to sincerely believe UNUM had no responsibility
to show that the pre-existing condition had some relationship to the
disability. During the six months prior to obtaining the UNUM policy, I
was getting routine allergy shots and saw my allergist once for a sinus
infection. No sane person would think this caused me to catch a
mycoplasma infection, but UNUM seems to believe they can exercise that
clause if medical treatment was received for any reason at all!

What bothers my employer is that UNUM's efforts at "cost containment"
are not balanced by a reasonable effort to provide good customer service
to employees. I am in a desperate situation financially and being
hounded by creditors does not facilitate my recovery.
Robert Lessman, (ASQ) CQA #16411     lessman AT bpr9000 DOT com
BPR 9000 Incorporated                http://www.bpr9000.com/
2086 Walsh Avenue, Suite C           408-727-2636 Voice
Santa Clara, CA 95050                408-988-1197 FAX only

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Created: September 24, 1998
Last Updated: May 28, 2000