One daughter has paid a premium for years. Has an issue currently that the doctors put her off work for six weeks. The insurer denies benefit. This is the second time they have done this stunt to her over the years. I am now starting to really wonder if anyone collects without threatening court action.

Plus where is law enforcement as it is a fraud when they do it over and over again. Civil case only if random but I think if they were claims audited criminal fraud with intent might prove obvious.

Americans may be more conditioned to this type of thing but it still would leave a bad taste in their mouths as well. The daughter is fortunate she does not need the money but many that buy that plan might very well.

I can no longer believe what I read with insurance company issues. It has to be fake. A lady in America claims she was denied coverage because of a previous condition. Specifically a bladder infection years ago. Not related at all to her current medical problem. I tell myself this must be fabricated.

Although one of our son in laws had to sue blue cross a few years back. His legal cost was 100k and he did prevail. They settled just before the court date. His was on a longer term disability issue.

Many insurance companies might illegally be wrecking peoples lives. They seem to be breaking legal contract laws with intent. Plus not persecuted by the existing criminal laws for doing it.


In our daughters case they had no issue with taking the premium over the years. Nor an issue with the son in laws premiums.

There's a lot more to the story here that we are missing...

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TC
Current stable:
- 2004 Mazda RALLYWANKEL
- 2007 Saturn sky redline
- 2004 Explorer...under surgery.

Past: 135i, GTI, 300E, 300SD, 300SD, Stealth

Son in laws claim was based on a serious back issue at work. The claim was paid for a short time. Blue Cross. They stopped paying although they were well aware the circumstances had not changed and the doctors verified this. As for that daughter.

The doctor decided that the daughter needed a rest from the stresses of her job. So he put her off work for six weeks. Her job is to deal with any customer complaints at the end of the road. In other words when the complaints have not been settled earlier on with less competent employees.

She has done this job for many years. They even pay her well. Also she has mentioned to me the general public are either under more stress than ever. Or something is making them act out in much higher numbers when dealing with them.

Their primary complaint is the high monthly cost of the services they buy from the company. They want to keep them all but do not want to downsize to what they can afford.

I had mentioned to her that indeed their costs are high and with no wage increases many are under the gun with the overall cost of living increases in our region. The disounted service package you buy from your company is about three hundred and fifty a month. They would pay more and the cost does not bother you but I can see where it could seriously be an issue to many others.

They are users of the the system being the general public and now treat her like she is and owns the corporation and have become very abusive in the last while.

We as a household pay 200.00 a month for high speed internet, landline phones, cellphone and television feed. This is as cheap as it gets locally.

I think the problem she is running into is younger customers that want every last bell and whistle their system can provide but lack the means to afford it. Kind of an entitlement issue is happening in those customers minds.

Just a guess but the customer relation problem has deteriorated in the last year or so signifigantly. They do not want to purchase cheaper packages in all too many cases.

Simplistically it was driving her over the edge. As customer retention was also her primary function. Plus they were well wound up by dealing with earlier customer service staff before reaching her. I also attribute part of the problem in that she services customers in the oil patch area of Canada from the east coast of Canada as well.

A horrific number of those people lost their high paid employment when the oil price dropped through the floor. Far too many have lost their homes and where heavily financially commited based on their previous high wage factor.

So she is in a way dealing with desperate people for the last year or so as well. Many can no longer almost keep a roof over their heads. Yet seem unable or unwilling to cut back. Our doctor is of the old school. He will not put someone off work unless he feels it is really needed. I was starting to see the stress in her face before the doctor put her off.

Has she seen a specialist that concurs with he doctor?

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1987 560SL
85,000 miles

Not to my knowledge. You would think she would let all the obsentities etc. Roll off her like water off a duck. Since her primary function is to retain revenue for the company besides solve issues she cannot just hang up or disconnect.

Unfortunatly for her she also cares for people as well. Perhaps the customers distress especially from the oil patch region was getting to her. Burnt out is probably what the doctor thought.

My guess is she might seek alternative employment. Too bad as she worked from home and runs a part time business as well. That is not too demanding. Plus I felt the employer paid much higher than average in our area for her. She also has enormous people skills.


Another daughter told me that she was putting up with far too much with the job as well in the last while. The actual employer is a local billionaire. He owns a lot of companies I have heard. So they may find something else for her to do.

PCP telling her to take some time is not enough to cause STD to pay...she needs specialists notes and such. Anyone can fool a PCP...

Sent from my soup cans and twine using Tapatalk

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1987 560SL
85,000 miles

Unfortunatly you are probably right. I know doctors that would probably just write up something on just essentially a request.

Three of the four daughters have the smarts like their mother. She is one of them so the end solution will be interesting.

Those three girls almost always suprise. I could post what actually transpires with this. Thats if the members where interested.. I can assure you it will be interesting. Those three girls never ever disappoint in finding solutions to problems. They manage in one way or anther to blow me out of the water more times than not.

Having the owner be a billionaire and dealing with unhappy customers has absolutely no bearing on STD payouts. It has everything to do with her doctors diagnosis and the coverage she has, just like any other coverage. It sounds like a pretty tough situation, but everything you mention above is tangential to why she would have been approved or denied. Hopefully she can figure it out and get it sorted out.

__________________
TC
Current stable:
- 2004 Mazda RALLYWANKEL
- 2007 Saturn sky redline
- 2004 Explorer...under surgery.

Past: 135i, GTI, 300E, 300SD, 300SD, Stealth

Not a tough situation for her. As much as the so easily displaced contract of the insurance company was the issue. She is more than fit to work in another environment.

My guess is she applied for the benefit as soon as the decision was made by the doctor. She is no longer qualifying . Instead she took measures well before this rejection letter arrived. So she would not have collected anyways.

She is involved with a new arrangement that if acceptable to her will probably be where she remains. I seriously doubt she will return to the old company. She has a few more weeks to decide.

I'm not sure how it works in Canada, but short term disability only pays if she's unable to work. If she was physically broken, that wouldn't be an issue. But "stressed" is a mental health condition which the company would look at very closely. Apparently she's not so bad that she can't find employment. So disability would be tough to justify to the insurer. It sounds like she had a miserable job, and the best solutuon was finding new work.

Sounds like your daughter works in the department known as Customer Recovery. This is the department that handles the worst of the worst over the telephone. IT IS AN EXTREMELY HIGH STRESS JOB. People are getting more and more demanding nowadays and believe they have the right to be a complete JACK A** over the phone. I have some friends who work in this area and believe me, the job itself is a living hell.

I couldn't handle it; I would HANG UP on them within the first ten seconds of being on the receiving end of their customer abuse.

Here's an idea; ask the jerks at the insurance company if they would be willing to work at her job taking high stress phone calls from pi**ed off customers eight to ten hours a day.

They will approve her disability payments PRONTO.

I am 60 plus and have seen the changes in the younger generations parade by.


People seem to think that what ever they believe is true and right regardless of the facts.


Then there is an unwillingness to read the fine print (that includes me) and or an inability to understand what they are reading.


I am also guessing that a larger issue is that the disgruntled customers your Daughter are dealing with were/are paying for services with their Credit Card/s. If those Customers cannot afford to pay off your Credit Card debt their ship is sinking; hence their panic or hysteria.


Then the younger generations have been bombarded by media that tells them what they are supposed to have to have a good life.


My older generation was taught that you are only ever going to have what you earned and or saved. If you did not earn enough you did without or tried to get a better job and or jobs.


Note that a lot of ads for a combination of internet-cable TV and wireless services can be somewhat deceptive and while you get a good deal for several Months after that you are stuck paying the higher rates. You also lose out if your cancel before your contract ends.


Anyway best wishes to our Daughter.

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84 300D, 82 Volvo 244Gl Diesel

I once had a job that effected my digestive track. I cared about the job and wanted things to be different but that was not going to happen.
I got tired of the pain and simply decided that caring was hurting me too much.
It took me about 3 weeks to train myself not to care and my digestive issues went away.


So your Daughter needs to do something similar. Caring too much about things you cannot control has you hitting your head on the wall.


I mean the Customers had a responsibility to take care of themselves and not purchase things that they cannot afford or stop service on things they cannot afford.
Also it does not sound like your Daughter is dealing with stuff that is life or death like health care issues.

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84 300D, 82 Volvo 244Gl Diesel

I think it is funny that she was given time off for stress and then the Insurance Company becomes the one causing more stress.
I think the answer is that if she had vacation time she could use that time for the stress issue.
Also I be the Insurance Company has someone that does a job to your Daughters. If you Daughter complained to that person that person would understand.

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84 300D, 82 Volvo 244Gl Diesel