In 2008, the American Association for Justice (AAJ) issued a report called The Ten Worst Insurance Companies In America. Although it didn’t come in as worst - that honor was reserved for Allstate - Unum came in second worst.
“Unum’s behavior was epitomized when it denied the claim of a woman with multiple sclerosis for three years, stating her conditions were ‘self-reported,’ contrary to doctors’ evaluations,” the AAJ writes in a press release that accompanied the report. That woman was actually Debra Potter, who sold Unum’s own disability policies until her multiple sclerosis made work impossible. Despite repeated communications from physicians stating Potter’s condition was legitimate and the Social Security Administration finding Potter totally disabled, Unum continued denying her claims until she hired an attorney.
“Unum, one of the nation’s leading disability insurers, has long had a reputation for unfairly denying and delaying claims," the AAJ writes in its report. An investigation by the California Department of Insurance into Unum reportedly found the company “systematically violated state insurance regulations,” including fraudulently denying claims through fake medical reports. The situation was bad enough that then-California Insurance Commissioner John Garamendi called Unum an “outlaw company.”
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Not all insurance claims are unfairly denied, and insurance companies have an obligation to ensure claims are legitimate before they are paid. But too often, claims are denied not because they are not legitimate, but because insurance companies are protecting profits or pushing employees to meet quotas for denials. In such cases, where legitimate claims are denied without being properly investigated - or worse, denied based on fraudulent paperwork - policyholders can file appeals or lawsuits to have the decision reviewed.