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Unum Provident Denied Disability Claims FAQWhat is Unum?
Unum insurance company is a Fortune 500 company that provides long term and short term disability, group life and long term care insurance for more than 100,000 companies and insures more than 25 million people worldwide. Unum is the worldâs largest individual disability insurance carrier. Unumâs predecessor, Union Mutual Life Insurance Company, was founded in 1848, and is based in Chattanooga, TN. It was one of the first major US mutual insurance companies to convert to public ownership, forming Unum Corporation in 1986.
Is there a difference between Unum, First Unum and UnumProvident?
No. Unum Life Insurance Company of America is formerly known as UnumProvident and First Unum. In 1997 Provident completed the acquisition of rival insurer The Paul Revere Corporation and its subsidiaries. Unum and Provident merged in 1999, creating UnumProvident Corporation. The company shortened its name to Unum in January 2007 in an effort to re-brand itself.
Why did UnumProvident need to re-brand and change its name to Unum?
In 2002, The 60 minutes program exposed Unum's bad faith policies, which showed nearly 3,000 lawsuits filed against Unum in the previous five years. As well, between 1992 and 2002 an estimated 10,000 lawsuits for denial of long term disability claims were filed against Unum Provident.
Did the government do anything about changing the Unum bad faith insurance practices?
Yes. In 2005 after several class action lawsuits charged that Unum illegally denied disability claims, The Department of Labor mandated that Unum Group is unfair and unjust and that Unum needs to resolve its bad faith practices.
New York State Attorney General Elliott Spitzer granted an Unum 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.
In 2008 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.
What is long term disability insurance?
Disability income protection insurance provides financial benefits to employees when they are unable to work due to a disability caused by an illness or injury covered under the insurance policy, regardless of whether or not that illness or injury is work-related.
You can get long term disability (LTD) insurance coverage either on an individual basis or through your employer. If you become disabled due to sickness or injury and are unable to work for an extended period of time, LTD benefits will provide you with a percentage of the income you earned through employment, which is usually around 40 to 60 percent of your gross income. A number of LTD policies require a 90-day waiting period from the onset of the disability before you can apply for benefits. Sometimes you can be covered by short term disability (STD) or you can elect for a shorter waiting period, but this will increase the premium on your policy.
What is the difference between Unum LTD disability and Workers' Compensation?
Workers' compensation supplements a worker's income in cases of sickness or injury that resulted from an on-the-job incident. LTD supplements an individual's income regardless whether the injury or accident happened at work. In some instances you may be eligible for workers' compensation and LTD insurance benefits.
Unum offered to help me with my Social Security Disability Insurance claim--should I let them help? How does LTD insurance work with social security benefits?
In some circumstances it may be advisable for you to pursue a social security disability insurance (SSDI) claim in addition to your LTD claim. These benefits can help "offset" your LTD benefits and make it less likely that Unum will "target" your claim for a denial. And if you have to fight a denial, the extra benefits may provide an alternate source of income. In some cases, Unum will offer to assist you with your social security claim. Beware of such offers because Unum is likely to share information from your social security file in order to use any information they can to deny your claim. And they often demand that you pay back any social security benefits. If Unum has made this suggestion to you, speak with an experienced health insurance attorney.
How does Unum deny benefits?
Unum may deny claims based on a number of pretenses including, but not limited to, the severity of the injury, lack of documentation, failure to provide documentation in a timely manner, and other related reasons.
Some possible 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
- Arguing that the claim is a pre-existing condition
- 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
Yes, there have been Unum lawsuits. 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 claimsâwhere 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.
What can I do if Unum denied LTD benefits?
Unum continues to deny or deny eligible claims and LTD benefits. You have the right to appeal Unum's decision. 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. It's best to contact an attorney who specializes in Unum lawsuits.
Unum denied my claim by saying I had a pre-existing condition--can they do that?
A pre-existing condition typically means any health condition you already have --including an injury that happened prior to the effective date of the insurance--when you enroll in a health insurance plan or policy. Unum often practices bad faith by claiming pre-existing conditions: a health insurance attorney. can help determine if Unum has acted in bad faith by denying pre-existing conditions.
As well, Unum may deny health insurance coverage due to a pre-existing clause, and that may be a federal offence. Both federal and state governments protect individuals from unreasonable denial of health insurance benefits for pre-existing conditions. In 1997, the HIPAA, or Health Insurance Portability and Accountability Act, was passed by the federal government to protect consumer rights with regards to pre-existing conditions for health insurance.
Do I need an experienced disability lawyer?
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 a lawyer who specializes in disability denials.
How long will my denied Unum benefits claim take?
Each case has various circumstances and there is no definite answer to this question. Most cases are settled out of court. The process can take a few months; sometimes it takes longer. However, an experienced attorney will ensure that you receive the benefits you deserve as soon as possible.
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Last updated on Nov-4-10