Unum (formerly known as Unum Provident and First Unum) has systematically denied Unum disability insurance to thousands of policy holders in the past two decades. Unum and its subsidiaries, including Provident Life, The Paul Revere Life Insurance Company and Colonial Life & Accident Insurance Company have been subject to numerous lawsuits for illegally refusing to pay valid disability claims.
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Unum Denied Disability Benefits
Unum has written disability insurance policies for approximately 17 million Americans, making it the largest disability insurance provider in the US. And it has denied countless insurance claims. Unum policyholders have filed disability lawsuits—personal injury cases—against the insurance company for practicing bad faith insurance and denying their Unum long term disability insurance.
Unum Denial—Am I Eligible for Benefits?
If you have had your claim denied, or if your claim was granted and then later terminated, you may be eligible for substantial additional benefits.
Under investigation and pressure from the Department of Labor (DOL), Unum Provident's family of companies offered to reassess approximately 200,000 claims denied or closed since January 1, 2000 for reasons other than settlement, death, or reaching benefit maximums. They were ordered to allow for reassessment, upon request, of claims similarly denied or closed between January 1, 1997 and December 31, 1999. According to the settlement, Unum accepted and reevaluated claims, whether or not the claimant was still disabled, until December 31, 2006.
If you have made a claim under a long-term disability policy provided by or administered by the following companies and have had your claim denied, or if your claim was granted and then later terminated, you still may be eligible for substantial additional benefits:
First Unum Provident Corp.
Unum Life Insurance Company of America
Paul Revere Life Insurance Company
Colonial Life & Accident Insurance Company or
Provident Life & Accident Insurance Company
Unum Denial Tactics
Some examples of Unum's Denial Tactics include:
Changing policies after claims are filed (and without the authorization or knowledge of policy holders)
Improperly investigating the claim and obtaining opinions from unqualified people/supposed experts
Misreading medical records, often by their independent medical examiners
Demanding repeated requests for independent medical examinations or denying a claim without any medical examination
Refusing to acknowledge their disability, especially mental disorders, fibromyalgia, and chronic fatigue syndrome
Denying a claim with the intent to wear the claimant down to a lower settlement
Partially paying a claim for total disability
Use of detectives, friends, co-workers and neighbors in an attempt to discredit the disability
UnumProvident (formerly "the Unum Group," a large Fortune 500 insurance company based in Chattanooga, TN) and its subsidiaries offer individual and group insurance programs such as long-term disability income protection, short-term disability income protection, life insurance, long term care insurance (LTCI), and voluntary critical illness insurance. Unum Provident insures more than 25 million people worldwide.
Disability income protection insurance provides financial benefits to employees when they are unable to work due to a disability caused by a covered illness or injury, regardless of whether or not that illness or injury is work-related.
Lawsuits filed against Unum or Unum Provident allege the company committed fraud and breach of contract. Many lawsuits stem from denial of legitimate Unum long term disability insurance claims—where the insurance company unfairly and improperly fails to compensate the insured for a loss covered by their policy, or unreasonably delays making payments due under the policy.
A federal court jury ruled in favor of John Tedesco, a former ophthalmologist who claimed the insurance company denied his disability claim even though he had been diagnosed with Parkinson's disease and a herniated disc. Tedesco was awarded $36.7 million.
The 60 minutes program broadcasted that Unum's policies led to nearly 3,000 lawsuits in the previous five years. Between 1992 and 2002 an estimated 10,000 lawsuits for denial of claims were filed against Unum Provident.
Former Unum "customer care specialist" Linda Nee brought about a whistle-blower lawsuit against UnumProvident Corp., claiming she was fired after bringing reports of wrongdoing to the attention of her supervisors. The suit alleged that Unum engaged in a pattern of delaying, denying and terminating benefits without regard to the merits of the claims.
Unum Provident declared it paid $4.2 billion in disability benefits and reserved $25 billion for potential claims.
The Department of Labor mandated that Unum Group is unfair and unjust and that Unum needs to resolve its bad faith practices, but many insurers have still been illegally denied their disability benefits and likely have a viable legal claim against Unum.
After investigating alleged unfair claims-handling practices, New York State Attorney General Elliott Spitzer granted an Unum lawsuit class action status. A multi-state investigation was resolved and the settlement required Unum: (1) to reassess approximately 200,000 claims that previously had been denied; (2) to completely restructure its claims-handling procedures to ensure objectivity and fairness; and (3) to pay a $15 million fine.
A federal judge in San Francisco upheld a jury's $7.67 million verdict against Unum Provident in a suit filed by former Berkeley chiropractor Joan Hangarter, saying the company had engaged in a wide range of questionable activity to avoid paying legitimate claims and ordered it to "obey the law."
A class-action suit filed in New York charged that UnumProvident operates "disability denial factories," wrongly denying disability claims by UnumProvident policyholders with mental disabilities. The class action alleges that UnumProvident "has illegally victimized, and continues to victimize, many thousands of disabled Americans." It seeks unspecified damages and asks the courts to order the company to re-evaluate all of the claims it has denied in recent years.
Unum issued a statement saying it insures 25 million people and has a complaint rate below the national average. It says it denied "only 1.5 percent" of 421,000 disability claims filed this year.
A class action suit was filed against UnumProvident/Unum alleging it had had engaged in a bad-faith plan for years to illegally deny or terminate the long-term disability claims of thousands of disabled American workers.
A California jury awarded a $31.7 million damage verdict against Unum Provident after it refused to pay Dr. Randall Chapman's $11,600 monthly benefits called for in a long-term disability policy that he purchased in the 1980s. Chapman developed a phobia that caused him to shake and could no longer perform eye surgeries.
Unum processed almost 400,000 disability claims and paid out more than $4 billion in benefits. According to the New York Times, Unum reported revenue of $10.5 billion. Operating income was reported up 31 percent.
Unum Group agreed to a $40 million settlement in a federal class action lawsuit that claimed the Unum Group (as UnumProvident) made misleading statements to investors in 2000–2003 to artificially inflate its stock share price. The lawsuit further claimed that Unum Provident used certain improper claims-handling practices.
Two qui tam (whistleblower) lawsuits were brought against Unum and Cigna Corp under the False Claims Act on behalf of whistleblowers. Attorneys alleged that the insurance industry sent tens of thousands of dubious disability claims to Social Security, costing the system hundreds of millions of dollars over the last decade.
A Boston jury found that Unum defrauded the US by forcing its customers to submit false claims for disability benefits to the Social Security Administration (SSA), when Unum knew that they were not eligible for government benefits. Unum forced some of its policyholders seeking disability insurance to apply for Social Security disability benefits even though they were not eligible, and thereby playing a major role in Unum bankrupting Social Security, which has much stricter criteria for disability benefits than private insurers such as Unum. In an attempt to gain more profits, Unum told thousands of claimants that it would cut their private disability benefits in half -- or more -- if they did not comply with Unum's directive that they must apply for Social Security disability benefits.
Senator Charles Grassley (R-Iowa) sent a letter to Unum and eight other private disability insurers asking for detailed information about the very practices that have now been deemed illegal.
A federal court in Kansas held that Unum was arbitrary and capricious to deny benefits based on a policy exclusion that the claimant's ("Kathy") fibromyalgia was a self-reported condition. The court agreed to vacate the record of its decision against Unum that it had improperly discontinued Kathy's long-term disability benefits in violation of the Employee Retirement Income Security Act (ERISA). Unum settled with Kathy for an undisclosed amount.
Unum Group (NYSE: UNM) reported net income of $199.4 million ($0.60 per diluted common share) for the fourth quarter of 2009, compared to net income of $41.8 million ($0.13 per diluted common share) for the fourth quarter of 2008. A spokesperson for Unum said, "The Company had another solid quarter and we closed the year well positioned for the year ahead… The Company is maintaining its previously stated outlook for full year 2010 and anticipates operating earnings growth for the year to be in a range of four percent to six percent."
Statistics show that plaintiffs generally win higher settlement awards if they work with an expert insurance attorney. To find out whether or not you have a legitimate claim against Unum, you should speak to an Unum lawyer that specializes in disability denials.
UnumProvident Disability Legal Help
If you have had a disability claim denied, or if your claim was granted and then later terminated, from one of the companies listed above, you may qualify for compensation, even if the statute of limitations has expired. Complete the form below for a free case evaluation.
Chattanooga,TN: Many policyholders collecting long-term disability benefits with Unum insurance are sadly surprised when Unum reduces their checks each month by the amount they receive from Social Security benefits - which Unum demanded they apply for. And some policyholders don’t want to give up that lump sum of back pay from Social Security. But Unum can sue, and win, to recoup an overpayment [READ MORE]
Victorville, CA: Despite two medical reports claiming that Isaac cannot yet return to work, Unum, or Unum Provident denied his disability benefits. “Unum didn’t even send me to one of their independent medical examiners and I don’t see how they could have even read my doctors’ reports,” says Isaac [READ MORE]
Seattle, WA: For most Unum, or Unum Provident, policyholders, trying to comprehend the role ERISA plays in Unum denied disability claims is like groping in the dark. Disability attorney Chris Roy sheds some light [READ MORE]