Category Archives: Arbitration

Thrivent claim news, Dr. Grover office contact, Sincere investigation attempt?, Records not requested in 2017 contrary to Thrivent letter statement, Mediation session sham

Thrivent claim news, Dr. Grover office contact, Sincere investigation attempt?, Records not requested in 2017 contrary to Thrivent letter statement, Mediation session sham

“Companies don’t want to go to court because it puts them on a level playing field. Courts are ruled by law, legal precedent, and legal discovery, which allows litigants to obtain information and evidence from their opponents or from third parties.”…North Carolina Consumers Council

“The insurance companies understand that if they deny and deny claims, then many of the claimants will never pursue their claim,”…ABC News Good Morning America April 25, 2008

“Companies And CEOs Rarely Admit To Wrongdoing”…NPR Sept. 20, 2013

 

From Citizen Wells October 15, 2018.

“I have in my possession startling new evidence which explains the “Alice in Wonderland” responses and requests I received from Thrivent personnel and agents during the processing of my disability claims.

I am requesting that you examine the letter your senior claims examiner sent to the NC Insurance Commission on  August 10, 2018 and take the appropriate actions.

If I were in your shoes, after examining and reviewing the evidence, I would immediately issue an apology and make reparations.

In the absence of those Christian responses, I am requesting again that we proceed to mediation instead of Thrivent’s insistence on perceived authority to mandate binding arbitration.”

https://citizenwells.com/2018/10/15/to-brad-hewitt-thrivent-financial-for-lutherans-request-for-mediation-based-on-startling-new-evidence-request-you-examine-august-10-2018-letter-senior-claims-examiner-sent-to-nc-insurance-commissio/

Has a sincere effort to investigate what has actually transpired in my claims case begun?

I received a call from Dr. Grover’s office on Tuesday, Oct. 23, 2018, at 3:00 PM, asking if I had given my permission for an insurance company to receive my records.

I answered yes.

Since this phone number did not match the one I had on record, I decided I must verify it. I also wanted to know if anyone had requested my records in 2017.

On Friday, Oct. 26, 2018, I called the number which was answered as Dr. Grover’s office. I verified my identity and asked if anyone had requested my records in 2017. I was told someone would call me back.

I received a call several hours later. No one requested my records in 2017.

Thrivent Attorney Wayne Luck during mediation and the same claims person who wrote the 6 page letter to the NC Insurance Commission with the nonsensical contract explanation, the  “Alice in Wonderland” protocol, tried to accuse me of falsifying records. The claims person in her letter to my former attorney stated that Dr. Grover’s office had no records for me. As you note above, Dr. Grover’s office had no record of Thrivent requesting my records.

I however, have multiple copies of documents proving Dr. Grover saw me multiple times.

At no time has Thrivent requested these records.

The hole is getting deeper.

I will not put off forever revealing the  “Alice in Wonderland” nonsense the Thrivent claims person wrote.

I hope that someone(s) at Thrivent is intelligent and moral enough to seek the truth.

Background on Dr. Grover controversy.

http://eachstorytold.com/2018/10/27/thrivent-claim-more-startling-new-evidence-of-fraud-or-incompetence-dr-grovers-office-called-consequence-of-alice-in-wonderland-protocol/

 

More here:

https://citizenwells.com/

http://citizenwells.net/

 

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Companies and CEOs rarely admit to wrongdoing,  Lawyers won’t let them, An apology helps to subtract the insult from the injury, thereby minimizing the injured party’s anger toward the offender

Companies and CEOs rarely admit to wrongdoing,  Lawyers won’t let them, An apology helps to subtract the insult from the injury, thereby minimizing the injured party’s anger toward the offender

“How might my behavior be perceived if it appeared in social media feeds, on the news or in tomorrow’s headlines?”...Thrivent “Code of Conduct”

“do unto others as you would have them do unto you”… Matthew 7:12

“An apology helps to subtract the insult from the injury, thereby minimizing the injured party’s anger toward the offender.”…Jonathan R. Cohen, Assistant Professor of Law

 

From NPR.

“Companies And CEOs Rarely Admit To Wrongdoing”

“SONARI GLINTON, BYLINE: Here’s a lesson we’ve all probably learned from our parents: When you’re wrong, say you’re sorry; fess up, admit it. These are toddler lessons – “Sesame Street,” “Mister Rogers.” So why do companies and CEOs so rarely admit that they screwed up?

KATHERINE PHILIPS: My cynical answer is, the lawyers won’t let them.

GLINTON: Katherine Philips is a professor of leadership and ethics at Columbia’s business school. She says one of the main reasons companies like JPMorgan don’t usually admit to wrongdoing, is because that will open them to crushing liabilities from plaintiff’s lawyers.

But Philips says there’s another element at play.

PHILIPS: One of the basic kind of psychological needs of human beings is to save face – right? – and to not look stupid, and not look like they don’t know what they’re doing. And people who are in powerful positions, and in charge, oftentimes feel that pressure even more so.”

Read more:

https://www.npr.org/2013/09/20/224296660/why-companies-and-ceos-rarely-admit-to-wrongdoing

ADVISING CLIENTS TO APOLOGIZE

Jonathan R. Cohen, Assistant Professor, University of Florida, Frederic G. Levin College of Law.

“Such factors prompt a question: Should lawyers discuss the possibility
of apology with clients more often? In this Article I argue that, in civil
cases, lawyers should discuss with clients the possibility of apology more
often than they now do.11 Not only is apology morally right and socially
beneficial, but in many cases making an apology is in the client’s (defendant’s)
best interest. This is not to say that there are no risks associated
with apology, not the least of which is the fear that an apology can be used
against one’s client in court as an admission of fault. However, when attention
is paid to the context in which an apology is offered and how it is
made, often “safe” apologies posing relatively little risk of increased liability
can be offered. Further, the possible benefits of apology to the client
(defendant) are under-recognized.”

“An apology can be an important step in preventing future antagonistic
behavior, including litigation. When an injury has occurred, there is a root
question to be resolved: Are you (the offender) my friend or my foe? An
apology signals that the offender wishes to establish or re-establish a
friendly relationship. It is a way of saying to the injured party: “I am your
friend, not your foe.” Implicit in this statement is often a second one, “I
want to have constructive future interactions, not destructive ones.” As
one might expect, this approach frequently works: The offender’s apology
often catalyzes the injured party’s forgiveness.”

“Indignity can be a large barrier to compromise, and in many cases, an
apology is needed before other aspects of the dispute, such as monetary
compensation, can be settled. As Goldberg, Green, and Sander write,
“[At] times, an apology alone is insufficient to resolve a dispute, but will
so reduce tension and ease the relationship between the parties that the issues
separating them are resolved with dispatch.”30 This observation has a
public policy corollary to which I shall return later: If we want to encourage the private settlement of, rather than the litigation of, disputes, allowing
parties to make apologies soon after an injury is critical.”

“Apology and forgiveness may also offer paths for spiritual and psychological
growth. By apologizing for, rather than denying or avoiding,
the damage he caused to his neighbor’s window, Hank becomes a better
person. By failing to apologize, Mr. Tiller may no longer be able to look at
himself in the mirror, or, should he meet her again, look Ms. Jones in the
eye. Responsibility and respect, rather than denial and avoidance, lie at
apology’s core. Within many religious and ethical systems, offering an
apology for one’s wrongdoing is an important part of moral behavior, as is
forgiving those who have caused offense.”

“One strategic benefit of an apology is that, if the injured party receives
the apology early enough, she may decide not to sue. For a legal
dispute to occur, injury alone is not sufficient. The injured party must also
decide to bring a legal claim.36 Taking the step to make a legal claim is
often triggered by the injured party’s anger. An early apology can help defuse
that anger and thereby prevent a legal dispute.37 The lesson here is an
important one. While there are risks to making an apology, there are also
risks to not making an apology. Accordingly, even if an apology could be
used against the offender at trial as proof of the offender’s liability (a topic
I will address shortly), in some cases it may still make sense for the offender
to apologize. The economically oriented might describe such an
apology as a gamble that an offender should take if and only if the expected
benefits from doing so, which depend upon the extent to which an
apology would decrease the likelihood of suit, exceed the expected costs,
which depend upon the extent to which an apology would harm the offender’s
case at trial.”

“VI. CONCLUSION
It is easy to see our world the way it is, and lose sight of the way it
should be. When an offender injures another, one would hope that, to the
extent that the offender feels at fault, he would apologize. This is not only
sound morality, it is a good way to prevent protracted disputes. An apology
helps to subtract the insult from the injury, thereby minimizing the injured
party’s anger toward the offender. Without an apology, what might
have been a minor offense may escalate into a major dispute.

While one could argue that lawyers should discuss the possibility of
apology with clients more often because apologizing when one has injured
another is the right thing to do, which is true, or because society would be
better off if more offenders apologized, which is also true, I have not done
so here. Rather, I have argued that lawyers should discuss apology more
often with their clients because often doing so would make their clients
better off. (Discussing apology with clients may make many lawyers
worse off, but that is another matter.) In many cases, the potential benefits
of apology are great, and when care is taken in how the apology is made—
within a “safe” legal mechanism like mediation, and with attention to nuances
such as admitting fault without assuming liability if insurance coverage
is at issue—the risks of apology are small. While our laws could be
and should be reworked to make “safe” apology easier, our existing legal
rules allow apologies to play a much larger role in legal disputes than they
now do.”

Read more:

https://www-bcf.usc.edu/~usclrev/pdf/072402.pdf

 

More here:

https://citizenwells.com/

http://citizenwells.net/

 

NC insurance issues, Hurricane Florence ramifications, Mandatory arbitration impact, Most have no flood insurance, My disability claims impact

NC insurance issues, Hurricane Florence ramifications, Mandatory arbitration impact, Most have no flood insurance, My disability claims impact

“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

“Companies don’t want to go to court because it puts them on a level playing field. Courts are ruled by law, legal precedent, and legal discovery, which allows litigants to obtain information and evidence from their opponents or from third parties. Discovery is a privilege in arbitration, but not a right. Arbitrators can’t enforce subpoenas, meaning you have to file a lawsuit just to get a third party or a piece of information into the hearing. In open court, you don’t have to jump through nearly as many hoops. Further, judgments in court are often more favorable to the consumer, both in the rate of success and the dollar amount of judgments.”…North Carolina Consumers Council

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

 

Hurricane Florence and its subsequent short term and long term flooding impact has been dominating much of the news in NC.

The impact is much worse than most people realize due to the extensive flooding and the fact that most people affected by the flooding do not have flood insurance.

Those who do have insurance coverage may be in for another shock.

The mandatory arbitration clause that may be in their insurance contract and permitted in NC. If they do not get what they consider a fair settlement, they may not be able to litigate, to have an attorney protect their interest in a court of law.

From the North Carolina Consumers Council.

“Mandatory Arbitration Clauses Are Everywhere But Aren’t Good For The Consumer

MANDATORY ARBITRATION TIES YOUR HANDS AND PREVENTS YOU FROM GETTING PROTECTIONS AND REMEDIES AVAILABLE UNDER STATE AND FEDERAL LAW”

“Arbitration can be voluntary or mandatory. Voluntary arbitration is preferred as it preserves your legal rights. Mandatory arbitration, on the other hand, compels you to first submit to the arbitration process as a condition of buying or using a product or service before you take your case to court. In many situations, however, accepting a mandatory arbitration clause means you surrender your rights to further court action at any time in the future for anything.”

“Arbitration providers market entirely to businesses and their arbitrators often consist primarily of corporate executives and their lawyers. So, arbitration is tilted heavily in the favor of the company because the arbitrator is chosen by and paid for by the company. That arbitrator has a financial incentive to rule in the favor of the company in order to be chosen in the future by the company for other arbitration cases. But that doesn’t necessarily mean that the arbitration will not find for the consumer. But arbitrators aren’t required to take law and legal precedent into account when making decisions like in legal proceedings. And since arbitration is private, everything that happens behind those closed doors is supposed to remain secret, meaning there is no public review of the process and no appeal in the case of binding arbitration.”

Read more:

https://www.ncconsumer.org/news-articles-eg/mandatory-arbitration-clauses-are-everywhere-but-arent-good-for-the-consumer.html

I recently received a gift, a blessing, from the NC Insurance Commission regarding my disability claim with Thrivent.

I am not at liberty to release the information at this time.

However, the impact this has had on me is significant.

It is my story and the story of thousands, if not millions of others.

http://eachstorytold.com/2018/09/25/thrivent-disability-claim-denial-and-treatment-impact-on-my-life-2009-to-present-delay-and-deny-alice-in-wonderland-protocol/

From the NAIC, The National Association of Insurance Commissioners, August 15, 2016.

“Peter Kochenburger and Brendan Bridgeland, NAIC Consumer Representatives 
Section One: Why arbitration clauses should be banned”

“Insurers that would insist on mandatory arbitration of policyholder disputes have selected the forum that they believe will be more favorable to them than to their policyholders, if not on each individual claim then in the aggregate. However, manipulating the dispute resolution process in this manner conflicts with the duties insurers owe their policyholders and is not holding their policyholders’ interests “at least equal to their own.”

“If arbitration was truly a neutral forum rather than one favoring insurers, then there would be no need for an insurer to insist on its use before a dispute has even arisen. Insurers should utilize arbitration only when the policyholder has consented to do so after an actual dispute occurs (which is what the suggested amendment to the Model Unfair Trade Practices Act should accomplish), rather than requiring it in boilerplate language that the policyholder is very unlikely to read, could not bargain over the provision even if she did, and could not make an
informed decision at the point of sale on the merits. True freedom of contract, combined with the fundamental right to a trial, requires a knowing relinquishment of that right, which can only occur voluntarily once a specific dispute has materialized.”

Read more:

http://eachstorytold.com/2018/07/16/naic-banning-arbitration-clauses-in-insurance-policies-why-arbitration-clauses-should-be-banned-companies-that-include-pre-dispute-mandatory-arbitration-clauses-do-so-because-it/

Aside from continuing my disability claim struggle, I hope to play a part in removing mandatory arbitration clauses in insurance policies.

 

More here:

https://citizenwells.com/

http://citizenwells.net/

 

Insurance company intimidation tactics, Fraud allegations bullying, Manipulate situation by choosing what information is relevant, NC Statutes on unfair claim settlement practices

Insurance company intimidation tactics, Fraud allegations bullying, Manipulate situation by choosing what information is relevant, NC Statutes on unfair claim settlement practices

“For members who have found themselves in disputes with Thrivent, the retroactive change rankles. “You’re wondering how Lutheran organizations can treat their own customers that way,” says Mr. Tiedemann, an 83-year-old retiree who navigated the dispute-resolution process for more than two years before giving up.”...WSJ May 30, 2006

“The insurance companies understand that if they deny and deny claims, then many of the claimants will never pursue their claim,”…ABC News Good Morning America April 25, 2008

“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

 

How Do Insurance Companies Use Intimidation Tactics?

“One of the ways an insurance company may try to manipulate the situation is by choosing what information is relevant. If they discover some key information that wasn’t previously communicated to them, they might choose to punish you for not telling them, instead of simply assuming you had made a mistake and asking you to supply the missing information.”

“Unsubstantiated Fraud Allegations: Many insurance providers will allege that their policyholder is engaged in fraud by inflating the value of items in their claim, fabricating events resulting in loss or claiming loss of items that do not exist or were not lost or damaged. Sometimes these allegations will be loosely based on mistakes on a proof of loss form or be completely without any factual support. The objective is to intimidate a policyholder into accepting a lowball offer because of fears that the insured will face potential civil or criminal liability as well as having his or her claim completely denied.”

http://eachstorytold.com/2018/06/30/fraud-accusation-insurance-company-intimidation-tactic-common-intimidation-techniques-tactics-by-insurance-companies-are-unethical-illegal-obligation-of-good-faith-and-fair-dealing-toward-policyh/

From AcomHealth.

“It is a very common device for claims adjusters to allege “fraud” as a means to drive a minimal financial settlement with a provider. The claim by some insurance company employee that “overutilization” has taken place and that somehow, based on self-serving and unreal “guidelines” they are exploring legal action against the provider is, indeed, sobering and probably as intimidating as it is intended to be. As absurd and unethical as this behavior is, it is frequent and it is effective in driving low-dollar settlements by providers even for the most legitimate of claims.”

“While the exact language in the law regarding fraud may vary from state to state, the common elements necessary to prove fraud might be summarized as follows:

Fraud must be proved by showing that the defendant’s actions involved five separate elements:

  1. A false statement of a material fact,
  2. Knowledge on the part of the defendant that the statement is untrue,
  3. Intent on the part of the defendant to deceive the alleged victim,
  4. Justifiable reliance by the alleged victim on the statement, and
  5. Injury to the alleged victim as a result. Source:  Farlex Internet Free Dictionary”

Read more:

https://acomhealth.com/steps-prevent-defend-claims-insurance-fraud/

NC Statutes.

“§ 58-24-165. Unfair methods of competition and unfair and deceptive acts and practices. Every society authorized to do business in this State shall be subject to the provisions of Article 63 of this Chapter relating to unfair methods of competition and unfair or deceptive acts or practices”

https://www.ncleg.net/EnactedLegislation/Statutes/PDF/BySection/Chapter_58/GS_58-24-165.pdf

“(11) Unfair Claim Settlement Practices. – Committing or performing with such frequency as to indicate a general business practice of any of the following: Provided, however, that no violation of this subsection shall of itself create any cause of action in favor of any person other than the Commissioner:
a. Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue;
 b. Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies;
c. Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies;
d. Refusing to pay claims without conducting a reasonable investigation based upon all available information;
e. Failing to affirm or deny coverage of claims within a reasonable time after proof-of-loss statements have been completed;
 f. Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear;
g. Compelling [the] insured to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insured;
h. Attempting to settle a claim for less than the amount to which a reasonable man would have believed he was entitled;
 i. Attempting to settle claims on the basis of an application which was altered without notice to, or knowledge or consent of, the insured;
 j. Making claims payments to insureds or beneficiaries not accompanied by [a] statement setting forth the coverage under which the payments are being made;
k. Making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration;
 l. Delaying the investigation or payment of claims by requiring an insured claimant, or the physician, of [or] either, to submit a preliminary claim report and then requiring the subsequent submission of formal proof-of-loss forms, both of which submissions contain substantially the same information;
 m. Failing to promptly settle claims where liability has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage; and

n. Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement.”

More here:

https://citizenwells.com/

http://citizenwells.net/

 

 

 

 

 

 

To Brad Hewitt Chief Executive Officer of Thrivent Financial for Lutherans, My claims experience my background and thoughts, Request that you read and investigate facts, Opportunity to act out Christian beliefs

To Brad Hewitt Chief Executive Officer of Thrivent Financial for Lutherans, My claims experience my background and thoughts, Request that you read and investigate facts, Opportunity to act out Christian beliefs

“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

“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.’”…Thrivent v. Acosta Nov. 3, 2017

“Martin Luther may or may not have stated ‘Here I Stand’ but his actions certainly did.”…Citizen Wells

 

I have it on authority that Thrivent does not like what I have written about them.

I recently told the outside attorney who relayed this message that I endeavor to be accurate and do not lie.

I stated that if Thrivent finds any errors or wishes to respond with a rebuttal, I will accomodate them.

I also have not written about my later claims experience yet.

From my recent letter to

Mr. Mike Causey

NC Insurance Commissioner

” Most of my adult life was spent in IT. My first job was with a top 20 accounting firm in Greensboro. I taught college Computer Science for 5 years. The rest of my IT career was spent in higher level IT/management positions or in my own consulting firm. I represented 3 NC companies in Manhattan for their IT matters. I had the highest level of real estate licensing in NC, Broker in Charge until 2009. I have had 3 successful motions in NC court and zero failures.

I was baptized as an infant in the Lutheran Church, went through catechism class, was an acolyte, joined the church at age 12 and sang in a choir for years. The first time I was self employed in 1985, I took out a disability policy with AAL, Aid Association for Lutherans, a fraternal benefit society licensed to sell insurance in NC. They later became Thrivent. I believed I could trust them then.”

I have addressed to or copied Mr. Brad Hewitt, Chief Executive Officer of Thrivent Financial for Lutherans, multiple times over the years.

Someone(s) at Thrivent have read some of what I have written about them and my first claims experience

Mr. Hewitt, I hope this article reaches you.

  • From the “Thrivent’s Christian Calling” pdf: “Fraternal benefit societies have a common bond among members. Thrivent’s common bond is Christianity. We embrace the core Christian beliefs as articulated in the Apostles’ Creed”
  • From Thrivent vs Perez Sept. 29, 2016: “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.”
  • I can assure you that the “core Christian beliefs” touted in the above did not manifest in my claims experiences with Thrivent. The whole of my experience has been the recipient of adversarial and argumentative postures.
  • No one from the Thrivent headquarters/claims office ever expressed any concern over my well being or in truly helping me through difficult times. Not the least hint of living out Christian values.
  • I believe that your staff, especially your corporate and outside legal resources, believes they are right and I am wrong. I have dealt with numerous attorneys and their specialty is adversarial positions. They don’t however like being lied to. Your upper level staff has been misled.
  • My first claims experience, though simpler in scope, covers a lot of territory. It reveals much of a pattern I have experienced with Thrivent that may explain partly my last claims experience.
  • My first claims experience was presented here along with a summary. It contains indisputable facts that explain my level of frustration and dissatisfaction with Thrivent. I strongly suggest you read it and investigate and then reach out to me.
  • The bottom line is that Thrivent used the wrong language on the claims form, the language that the doctor had to follow for date of disability. I was ignored and ultimately slandered and libeled by Thrivent personnel (I have the transcript). Thrivent later corrected the claims form. They did not apologize to me or make restitution to me for my ill treatment.
  • In a recent email I sent to your outside attorney I stated:
    “We appear to be at an impasse.
    I am an expert on business & business systems. Over 30 years experience,
    with customers with $ 5 million to over a billion in sales.
    I represented 3 companies in Manhattan.
    My proposal:
    Take this out of the legal/adversarial mode.
    Hire me as a consultant to explain what happened and to prevent it from happening again.
    They tout the MDRP program as benefiting the members and representing their core Christian values.
    What better way to exemplify it than to create a win win situation, heal our wounds & to fix any problems in the system.
    I am certain a bible verse applies.”
  • This was difficult for me to write after what has transpired with the financial, physical and emotional toll on me. However, it is closer to what I believe is a Christian posture.

Here I stand.

First claims experience.

https://citizenwells.com/2018/07/25/thrivent-incompetence-misrepresentation-fraud-my-first-claims-experience-not-unique-thrivent-touts-core-christian-values-and-beneficial-dispute-resolution-wolf-in-sheeps-clothing-directed-by-devi/

 

More here:

https://citizenwells.com/

http://citizenwells.net/

First Thrivent claims experience very frustrating, Claims person offended when I quoted Bible, Obviously did not understand contract, All business problems are management problems

First Thrivent claims experience very frustrating, Claims person offended when I quoted Bible, Obviously did not understand contract, All business problems are management problems

“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

“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.’”…Thrivent v. Acosta Nov. 3, 2017

“Martin Luther may or may not have stated ‘Here I Stand’ but his actions certainly did.”…Citizen Wells

 

From the recent letter I sent to the NC Insurance Commissioner attached:

“Larry Wells brief Bio”

 “I was baptized as an infant in the Lutheran Church, went through catechism class, was an acolyte, joined the church at age 12 and sang in a choir for years. The first time I was self employed in 1985, I took out a disability policy with AAL, Aid Association for Lutherans, a fraternal benefit society licensed to sell insurance in NC. They later became Thrivent. I believed I could trust them then”.

All business problems are management problems.

It is sometimes difficult to have empathy for someone who has caused you pain or problems.

It is easier however, with the passage of time, and proper reflection and sympathy to do so.

So it is with the Thrivent claims person I spoke to in 2002.

Thrivent, misrepresenting the contract, used “unable to work” on claims forms and in their conversations instead of the contract dictated unable to perform regular occupation.

I had numerous communications regarding this massive error and they were extremely frustrating, especially in the context of much pain and trying to take care of my essential responsibilities.

It was not only frustrating but surreal like being in Alice in Wonderland.

I referred to the forms as sleazy (trying not to use words like incompetent or evil) and according to the transcripts I obtained, used 3 different bible verses.

She was offended by my quoting the bible.

I quote the bible regularly.

Here are 2 of my favorites:

“And you shall know the truth, and the truth shall set you free.”…Jesus, John 8:32

“And Jesus went into the temple of God, and cast out all them that sold and bought in the temple, and overthrew the tables of the moneychangers, and the seats of them that sold doves,

And said unto them, It is written, My house shall be called the house of prayer; but ye have made it a den of thieves.”…Matthew 21:12-13

I was obviously influenced by Martin Luther.

“In fact, Luther says this is the most important reason to read and study the Catechism, because it grants the Holy Spirit, who brings us to faith in Christ and drives away the devil. Indeed, “for this reason alone you ought gladly to read, speak, think, and use these things, even if you had no other profit and fruit from them than driving away the devil and evil thoughts by doing so. For he cannot hear or endure God’s Word… Yes indeed, it is the power of God that gives the devil burning pain and strengthens, comforts, and helps us beyond measure.”[10] Read, repeat, meditate. Learn it by rote, so as to learn it by heart. Then you can take it with you to your deathbed and beyond.”

https://lutheranreformation.org/history/large-small-catechisms-dr-luther/

The poor lady was becoming almost as frustrated as I was. I truly believe she did not understand the contract nor how the claim forms were affecting me.

ALL PROBLEMS ARE MANAGEMENT PROBLEMS.

 

More here:

https://citizenwells.com/

http://citizenwells.net/

 

 

 

 

 

 

 

 

 

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/