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Thread: ANOTHER LTD overpayment & family benefits thread

Created on: 11/12/08 12:35 AM

Replies: 5

kkpace


New Member


Joined: 09/10/08

Posts: 5


11/12/08 12:35 AM

I received a lump sum from SS.. I have no problem with the fact that LTD covered me until SS kicked in, and that they should be paid back that amount. My challenge is that their calculation is WRONG. They blatantly lied to me about how the calculation worked and tried to give me the old "confuse" the issue until you give up trying to understand routine. What they don't know is I was an accountant for 23 years, and the logic of their calculation is in error, (this is not my opinion, it is a fact). In my case it adds up to several thousand dollars. I was told, "that's just ther way the calculation works", but, ... that doesn't make it correct. My thought is, if "that's the way we calculate it", then they may have mislead (to put it nicely) thousands of policyholders by deceptive logic in their calculation methods. I have not resolved anything with them as of yet, but I can shoot holes in their methodology... which I believe is not only erroneous, but may have been intentionally erroneous based on the illogical, misleading, intent to confuse arguments I was presented with.

I also have an 18 year old who presumably could apply for benefits, though I have no control over whether he does that. SS would then pay HIM (and that $ would be taxable to HIM). I have no claim on that $, nor would I have been able to anything to obtain it (other than be disabled). I cannot help that SS has a really stupid rule about paying "adult" children (over 18) directly. LTD says they will claim that $ as an offset. It is not my $, nor do I have any control in obtaining it, nor do I have any control what is done with it. How can I pay back something I never recieve. And if I happened to get my son to pay it back, he would still owe taxes on it... (as if my disability isn't burden enough). This seems unbelievable to me that they could ever win this kind of judgement... I've seen a few other posts about this... I am dumbfounded. I really don't care what the contract says (a contract I never signed), if it claims money that cannot be claimed then that part of the contract is void. I mean, what if the contract said, "upon SS approval, every member of your family, and all your neighbors must chip in $1000 to help repay this rich insurance company for the converage (or lack thereof) that they have provided." To me that is not enforceable... my son had nothing to do with my employers contract, he is just following what SS says they will pay...LTD has no contract with him, just like they would have no contract with my immediate family, or my neighbors (despite what the contract might say).

Another thing, while I am on a roll.... LTD, who claims to pay family benefits with the purpose of then reclaiming those SS family benefits as theirs, did not pay me one dime of "family" benefits. It was never a part of the calculation. They did however, manage to knock my "income" down materially by not including bonuses, additional PTO times, overtime wages, etc.. My question is this... how can they ask for reimbursement of family benefits when they paid NO family benefits? That , my freinds, is a very good question.

Anyone got any advice for me, I am ready to do battle... I will pay LTD exactly what they deserve, nothing more, nothing less.


EDITED TO REMOVE INSURERS NAME. CEM

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pkixer


New Member


Joined: 09/17/07

Posts: 2


11/12/08 1:22 AM

I am in the same position, I received a year of back pay from SSA and LTD wants it back, I used the money to pay off credit cards I used for treatments.
Can you elaborate more on why and how LTD is deliberately miscalculating the SSA benefit offset from the LTDpayment. If I am convinced they are doing this deliberately I am able to sue and open an investigation.

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kkpace


New Member


Joined: 09/10/08

Posts: 5


11/12/08 6:17 AM

1st off whatt they attempt to do is explain to you a bunch of malarky about how they pay in advance, while SS pays behind a month. The result of this incorrect (but soundingly convincing logic) is that they only in effect pay you for 5 of the 6 month waiting period that SS has. 1 month of benefits can be a lot. The timing of who pays what when should have nothing to do with the calculation. btw, they do not pay in advance. 2nd, I received an account adjustment, which was nice, but, the way they decptively added it, they conveniently skipped the 1st 6 months. And, apparently this is money I should have been paid from the start (mine took 4 years, it is a significant amount) - the interest I could have earned on what they should have paid me is over 2,000. They made it all sound nice, like they were doing me a favor - that is the heigth of hypocracy.

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RHonour


Member


Joined: 02/04/05

Posts: 345


11/12/08 9:44 AM

Hello kkpace,

Best of luck to you in your struggles with your overpayment calculation.

Not to want to stir the pot, but Social Security really does pay in arrears. Far in arrears, in my opinion.

Today, November 12th, I received payment from Social Security for the period of October 1 through 31.

In a "money saving" move some years ago, Social Security pays your benefits the following month, based on the day of the month you were born.

If you were born the 1st through the 10th of the month, you receive payment the second Wednesday of the following the month. The 11th through the 20th, it's the 3rd Wednesday. After the 20th, it's the 4th Wednesday.

So, for those born late in the month, your payment may be as much as 27 days into the next month.

As I said, not wanting to stir the pot, this is one of the elements of the backpayment calculation that you need to take into consideration. For reference, my own background is in accounting.

I totally agree with your argument that your adult son's benefits are paid directly to him and you have no control over whether or not he even applies. His benefits are paid on consideration of your disability and, unfortunately, the insurance contract is likely offsetting all benefits paid on consideration of your disability.

Another rub is that benefits paid to minor children, while paid to the beneficiary, are intended to be used solely in the care of those dependents.

Best of luck in your struggle. It's one that has been fought many times over offsets.

R.Honour

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FredK


New Member


Joined: 07/10/07

Posts: 26


11/12/08 10:07 AM

some of your facts are wrong

1. SS waiting period is 5 months not 6. check ssa.gov for correct information

2. What the contract says is relevant. It , not your opinion of what is right is what will decide how you claim will be paid.

3. If the contract calls for bonuses and ot wages not to be used in calculating annual wages then that is what your employer paid for and is what you will be paid based on.

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dave61599


Veteran Member


Joined: 07/28/02

Posts: 2,170


11/12/08 11:13 AM

You can ask for an itemized explanation where the numbers are provided for each and every month.


If the ltd benefits began in the 6th month then the first SSDI benefit was for the 5th month and should not be offset, Unless it was offset by STD.

In my case the insurance company did not offset for benefits paid to my dependent after they turned 18, However he got his first check before he turned 18 so they did not pay the additional amount for two months.

Read you plan documents The wording in them determines what the insurance company gets to offset.

Claims handlers do not always have the right policy in hand when they determine what they are offsetting.

It took over 7 years of telling the insurance company that they had not provided the right STD policy to me before they found out that I was right.

It took my department of insurance to help get things straightened out. The reassesment that my insurance company was forced to do allowed me to document where they had fallen short on handling my claim, I prepared my reassessment documents to be viewed by the DOI if I was not given my benefit. The did not give me my benefit and did not address the issues I presented.

When the DOI got involved and did not back down on requiring the insurance company to provide proper answers they paid instead of giving any answers.

After you have a copy of your companies policy and the itemized explanation of how your offset was figured you can find out from you DOI if they agree that the insurance company is figuring the offset according to the insurance law in your sate. Knowing the insurance law in your state as to offsets may help you in not needing to pay as much back to the insurance company.

The big one is where it has taken a long time in getting approved for SSDI and you dependent turned 18 before the benefit was paid so there was several years your dependents received back pay for when he was less than 18 but was paid directly to them.

You state determines what wording is acceptable in insurance policies, so the dependent when they turn 18 is partially determined by state insurance law and partially by what you former employer paid for

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