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Unum Policy: Deny Claims

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Seattle, WAIt's a more common occurrence than people might think: A hard-working, honest person faithfully pays into their disability insurance policy held through Unum Group (formerly UnumProvident). Every month money is deducted from their paycheck to pay for the disability insurance, but the worker is satisfied that their bills will be paid even if they are unable to work for an extended time.

Unfortunately, the unexpected occurs and the worker is seriously injured. His doctor tells him he cannot return to work because of his injuries. The man is upset but is comforted with the knowledge that at least his family will have some money coming in to help pay the bills, because he has a disability policy through Unum.

The man files his claim with Unum. He sends in his paperwork and required documentation and then he waits for his letter of approval from Unum.

Unum injured workerBut the approval letter never arrives.

Instead he receives a variety of reasons why Unum has declined his claim. He has sent in the wrong form, Unum's doctor believes his injuries do not prevent him from returning to work, or Unum believes he has falsified his claim. Whatever the excuse given, Unum has rejected the man's claim and will not hear his appeals.

The man has rising medical costs because of his injury and has fallen behind on his other bills. He now has to return to work early, against his doctor's medical advice, in order to pay his bills. If he does not return to work, he could lose his home. But returning to work means the man is worsening his injuries and extending his recovery time.

Sounds too absurd to be true? If you have a disability policy with Unum, this could be you one day. In fact, this may have already happened to you or someone you know.

Thousands of people have complained about the poor treatment they received from Unum, a company that found every excuse in the book not to approve claims. In some cases, even if Unum paid the claim it was grossly underpaid so the worker never received the amount he was entitled to under his policy.

Lawsuits have been filed by consumers who were unjustly denied their claims against Unum. These lawsuits allege that Unum officials set targets to save the company money and that doctors and claims adjusters were given incentives to meet those goals by denying or terminating claims.

One lawsuit alleged that UnumProvident used non-medical personnel to determine which claims should be denied and then had medical staff justify the decision. According to Dr. Patrick F. McSharry, who was fired in 2002 from his position as medical director for Unum, the purpose of doctors hired by Unum was "to provide language and conclusions supporting denial of claims." Furthermore, doctors had a daily quota of claims to review, which prevented the doctors from looking at the cases on an in-depth basis, and the doctors were forbidden from suggesting additional tests for policyholders.

Although Unum has denied the allegations, judges have found for the plaintiffs in the past. In 2002, a chiropractor who was driven into homelessness when UnumProvident denied her disability claim after a car accident was awarded $7.6 million dollars. The plaintiff suffered severe injuries in the car accident and was no longer able to work. After UnumProvident denied her claim, the plaintiff was evicted, her car was repossessed, and she was forced to declare bankruptcy.

The plaintiff's lawyer said internal memos from UnumProvident prove that it is purposely denying legitimate claims to save money. The judge agreed, and in his ruling barred UnumProvident from future violations including destroying medical records, targeting claimants for denial or termination of claims and hiring biased medical personnel.

Although that lawsuit was a few years ago, more lawsuits against Unum are being filed and allegations are still made that Unum is purposely denying legitimate claims. Recently, a judge granted class action status to a lawsuit that alleges Unum acted in bad faith by unfairly denying claims.

Unum cannot be allowed to take advantage of hard-working people who pay into their policies in good faith, only to have their claims unjustly denied.


Unum Legal Help

If you have had a disability claim denied, or if your claim was granted and then later terminated, please contact a lawyer involved in a possible [Unum Lawsuit] who will review your case at no cost or obligation.


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