Thrivent incompetence misrepresentation fraud, My first claims experience not unique, Thrivent touts core Christian values and beneficial dispute resolution, Wolf in sheep’s clothing directed by Devil’s Advocates

Thrivent incompetence misrepresentation fraud, My first claims experience not unique, Thrivent touts core Christian values and beneficial dispute resolution, Wolf in sheep’s clothing directed by Devil’s Advocates

“The MDRP is the sole means for presenting and resolving grievances, complaints, or disputes between Members, insureds, certificate owners or beneficiaries and Thrivent or Thrivent’s directors, officers, agents and employees. The MDRP reflects Thrivent’s Christian belief system and strives to preserve Members’ fraternal relationship.”…Thrivent vs Perez Sept. 29, 2016

“pre-dispute mandatory arbitration provisions are inappropriate in insurance policies and incompatible with the legal duties insurers owe policyholders when handling their claims.”…NAIC, National Association of Insurance Commissioners, August 15, 2016

“Beware of false prophets, which come to you in sheep’s clothing, but inwardly they are ravening wolves.”…Matthew 7:15

From my recent letter to Mike Causey, NC Insurance Commissioner:

“My first claims experience with AAL/Thrivent was 2001-2003. It was an eye opening experience. This was never intended to be a large claim or “war.” I did experience a series of incompetence, misrepresentation, adversarial responses and a great deal of frustration. I even learned later, after requesting conversation transcripts, that I had been slandered and libeled. This earlier experience, put aside because it was not a war, not life devastating, is resurrected in the context of being a pattern and not appropriately handled by the Insurance Commission in 2003.”

From Thrivent v. Acosta Nov. 3, 2017.

“Thrivent contends that its commitment to individual arbitration is ‘”important to the membership because it reflects Thrivent’s Christian Common Bond, helps preserve members’ fraternal relationships, and avoids protracted and adversarial litigation that could undermine Thrivent’s core mission.’”

They have avoided adversarial litigation and replaced it with adversarial claims processes and dispute resolution controlled by their Devil’s Advocates. This has benefited Thrivent.

Here is a summary of what transpired from 2001-2003.

• My knee went out early in 2001 (old football injury). My profession, computer consulting required much walking through warehouses and offices.
• I was diagnosed on 6/18/01 with “severe osteoarthritis with progressively increasing pain and lack of function.”
• Knee replacement surgery was scheduled for 12/17/01.
• The local Thrivent rep urged me to file a claim. I did so. It was the right decision and the impact on my life was more significant than I expected.
• My policy states that total disability is a disability that prevents one from performing their regular occupation. Clearly the date should fall between 6/18/01 and 12/17/01. I was unable to perform my regular occupation prior to surgery.
• The doctor filled out a claims form and indicated 12/17/01 as the date of disability. The date of surgery. Why? Because Thrivent used the terminology “Unable to work” instead of the contract language.
• I had a phone conversation with Thrivent claims, the beginning of a series of insane dialogues with people who were not listening about the disability.
• It is important to note that I was in much pain before, during and after surgery, unable to work and dealing with other life stresses. This is an elephant in the room of insurance claims.
• I received a letter from Ann Weyenberg of Thrivent dated 12/7/01 which states the correct contract language and reminds me to review the contract. Apparently I was the only one doing so.
• I was in the hospital 5 days. My surgeon said my knee was the worst he had seen.
• On 12/26/01, from a transcript I later obtained, Dave Burnette, the local rep, speaking to claims rep Jen Schroeder, uses the phrase “unable to work” instead of the proper contract language. Incompetence/misrepresentation is widespread.
• On 2/4/02 I had a conversation with claims rep Sandy Kruse. I referred to the claims form as a disgrace and the process sleazy. She obviously was trained to respond in a certain manner and had no clue about the contract. I later learned that she and Dave Burnette slandered and libeled me.
• I went round and round going back and forth between the claims people and the doctor getting nowhere but frustrated. There was a 3 month waiting period in the contract before benefits would kick in. I later learned there is more to that story and that is why they put so much effort into controlling the disability date.
• In 2003, on the recommendation of an attorney, I filed a complaint with the NC Insurance Commission. From my recent letter to the commissioner: “The first complaint I filed with the NC Insurance Commission was a travesty. Apparently no investigation was performed, no one requested more info from me and the word of Thrivent was taken as Gospel. I believe this has empowered them to believe they are untouchable.”
• This matter was put aside until I had a more serious claim with Thrivent.
• I had a more serious claim in 2009. The first encounter is fully documented and presented again to the NC Insurance Commission. One of the discoveries: Thrivent corrected the claim form to reflect the wording of the contract.

Below is some of the documentation.

“Thrivent letter December 7, 2001, Ann Weyenberg.

A disability prevents performing regular occupation.

And  I am reminded to review the contract.

Claim form filled out by Dr. Aluisio (smoking gun).

1. Notice, there is no date of disability per the contract language, the date unable to perform regular occupation.
2. Date patient became medically unable to work does not match the contract and is a Social Security definition.
3. Notice below that “Is patient medically able to return to the above noted occupation?”. Now they use contract language.
4. Notice part-time checked.
5. “Do you feel the patient is medically able to perform another occupation?” No checked.
6. Under Current limitations / restrictions: Standing and walking checked. The doctor and Thrivent had been notified that walking was an integral part of my profession.

Furthermore, the diagnosis from June 18, 2001 revealed a funtional loss and pain.

Clearly the date of disability should have at least been somewhere between 6/19/01 and prior to surgery on 12/17/01.

I had several conversations with Thrivent personnel about the wording, each time I was ignored. Apparently the worker bees had no concept of the contract and probably believed that “unable to work” was perfectly acceptable. Management and legal staff should know better.

On February 4, 2002 I had a lengthy conversation with Sandy Kruse. She appeared confused when I requested clarification of the term “earned income.” She had no concept of what I was talking about. I was still in pain and frustrated with Thrivent’s attitude. I called form DL259, that the doctor filled out a disgrace and the process as sleazy. Incompetent and/or evil are probably more appropriate.

After going round and round with Thrivent and getting nowhere, an attorney suggested I file a complaint with the NC Insurance Commission. I did so.

NC Insurance Commission complaint.

“An attorney advised me to file a complaint with the NC Insurance Commission. I did so on September 24, 2003.”

“After the so called investigation, the Commission responded.

As you can see, they take Thrivent’s word and do no real investigation. They did not contact me with questions or for more input.

However, it was not a total waste of time.

• This proves that Thrivent believed they were bound by NC insurance laws.
• This proves that Thrivent continued their incompetent/fraudulent position of using “unable to work” instead of the contract language and had the gaul to maintain their position with the NC Insurance Commission. Misrepresentation.
• Finally, Thrivent’s Ann Weyenberg, who wrote the December 7, 2001 letter quoting the contract correctly then, sent the following to the Insurance commission in a letter dated .October 14, 2003.

Ann Weyenberg begins:

“I’d like to explain some provisions of his disability contract:”

Really?

Notice that after “An occupation means the covered person’s regular occupation,” “but work part-time during the first 24 months of total disability.” does not match the contract language or the letter from Ann Weyenberg (see above) dated December 7, 2001.

Thrivent misrepresented the policy to the NC Insurance Commission!

Incompetence or Fraud?”

Read more:

http://eachstorytold.com/2018/07/10/thrivent-disability-claim-denial-complaint-to-nc-insurance-commission-no-investigation-just-echo-of-thrivents-statements-did-prove-thrivent-bound-by-law-and-their-misrepresentation/

In a letter dated August 14, 2004, Dr. Aluisio states why he used the date of surgery as the disability date.

It is obviously not the definition used in the policy. It is, as shown above, what Thrivent used on the claim form.

I do not know when Thrivent corrected the claim form, but if you retrieve one online now, this is what you see.

“Date patient became medically unable to perform activities listed above (mm/dd/yyy)“, which is correct replaces “unable to work”.

http://eachstorytold.com/2018/07/22/thrivent-disability-claim-denial-my-first-experience-part-4-thrivent-claim-form-doctor-forced-to-use-definition-provided-by-thrivent-unable-to-work-instead-of-contract-unable-to-perform-regul/