Unum Insurance Claims Denied

San Diego, CAHaving a disability claim denied by a company like Unum (formerly UnumProvident) can be emotionally and financially devastating. Many people have legitimate long-term disability claims but because companies like Unum focus more on the bottom-line than on people's healthcare needs, their claims are denied. Unum, and other long-term disability companies, often hope that the claimant will simply accept that the claim has been denied and go away. However, more and more people who have had their claims unreasonably denied are fighting back with lawsuits to force Unum to hold up its end of the contract.

Unum and other long-term disability providers count on the fact that once a claim is denied the claimant will give up, not having the financial or emotional resources to fight a long battle with a large company. After all, the more claims Unum denies, the less money it has to pay out and the more money it makes. Critics of Unum point out, in an article written for the Los Angeles. Times, that even if Unum denied only a small percentage of valid claims the company would save millions of dollars, especially if those denied claims were for highly paid workers. Unfortunately, everyone is at risk of having a claim denied, regardless of how financially stable they are, meaning that people living paycheck to paycheck could find themselves under severe financial stress by having a claim denied.

Unum and other companies use myriad excuses to deny or delay payment on a claim. Such excuses include: that medical records do not support a claim, that physical limitations do not prevent the claimant from performing occupational duties, and that applicants filed their claim after a deadline even if the insurer has told them to wait to file or has 'misplaced' applications. Unum has even told a man who had several heart attacks and triple-bypass that he was fit to work, despite never sending the man to see one of its doctors. The man won $240,000 in a lawsuit against Unum.

Lawsuits are now being filed against Unum for unfairly denying insurance claims. They became more prominent after former Unum employees alleged that they were given instructions to deny valid claims in order to increase Unum's profits. One former employee alleged that between $7 million and $14 million were targeted for denial each month. Furthermore, claimants who had subjective conditions that did not show up in MRI's or x-rays were more likely to be targeted for a claim denial.

Under legal settlements between Unum and state regulators in 2004 and 2005, Unum was required to reopen 290,000 claims that were eligible for a second chance. However, according to an article in the Los Angeles Times, fewer than 10% of those 290,000 claims will be reviewed by the end of the reviewing process. Unum says the low number is because most claimants chose not to reopen their cases, but consumer advocates say that many people still feel Unum's claims-resolution process is unfair and do not want to become involved in the system again.

Policyholders who pay into a long-term disability policy in good faith are entitled to the full benefits that they paid premiums for. Unum must be held accountable for its illegal actions. If you have been unfairly denied a claim by Unum (UnumProvident) or any of its subsidiaries, contact a lawyer to discuss your legal options.