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Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits

Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits August 14, 2018. By Jane Mundy.
Santa Clara, CA: As a disability claims consultant and former Unum employee, Linda Nee knows just about every trick in the insurance company’s books to dispute and deny disability benefits to claimants. She says that Unum, or First Unum is “nickel and diming” its policy holders by alleging overpayments associated with SSDI and other monthly earnings offsets, including Retirement Income.
Read [ Disability Claims Consultant Explains Unum’s Latest Practice to Dispute or Deny Long Term Disability Benefits ]

Hartford Insurance Denies Disability Benefits and Pays Millions to bail out a town

Hartford Insurance Denies Disability Benefits and Pays Millions to bail out a town August 13, 2018. By Jane Mundy.
Hartford, CT: Imagine that an injury results in you being disabled and unable to return to work. You apply for long term disability but Hartford, your insurance company, denies your benefits. You don’t have any savings and no other source of income. And then you find out that Hartford, along with two other insurance companies, bails out the town of Hartford for millions of dollars – and not even their policyholders. Wouldn’t you want to be part of that payout? Wouldn’t you be angry, to say the least?
Read [ Hartford Insurance Denies Disability Benefits and Pays Millions to bail out a town ]

Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics

Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics August 6, 2018. By Anne Wallace.
Washington, DC In July 2018, the American College of Emergency Physicians filed an insurance lawsuit against Anthem Blue Cross Blue Shield over the insurer’s new policy of denying emergency room coverage after the fact. As a subpart of the strategy, Anthem refuses claims for in-hospital CT scans and MRIs ordered in the course of emergency diagnosis and treatment. The lawsuit focuses on the harm the policy does to patients. But it also shines a light on the damage that Anthem’s plan does to hospitals and the wider healthcare system.
Read [ Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics ]

Sen. McCaskill Probes Anthem Emergency Room Coverage Denials

Sen. McCaskill Probes Anthem Emergency Room Coverage Denials July 28, 2018. By Anne Wallace.
Washington, DC On July 17, 2018 Sen. Claire McCaskill’s office released a report detailing the results of an investigation into Anthem Blue Cross Blue Shield’s efforts to cut costs by denying emergency room coverage after the fact. Many of these insurance claim denials were eventually reversed. But Anthem may have succeeded in its overall goal of dissuading patients from seeking emergency care. A bad faith insurance lawsuit filed with California’s Department of Managed Health Care further shows how a combination of intimidation and delay can wear patients down. The good news, though, is that claimants who persist often win.
Read [ Sen. McCaskill Probes Anthem Emergency Room Coverage Denials ]

Summary Judgment for Lincoln National in Barber v. Lincoln National Life Insurance Company

Summary Judgment for Lincoln National in Barber v. Lincoln National Life Insurance Company July 25, 2018. By Anne Wallace.
Cincinnati, OH On May 18, 2018, the Sixth Circuit denied Oliver Barber’s appeal in his long term denied disability lawsuit against Lincoln Financial (the marketing name for Lincoln National Corporation and insurance company affiliates). This is likely the end of the road for Barber’s lawsuit, but it was hard fought and thoroughly argued. There is a lot to learn from Barber about how to succeed in future long-term disability lawsuits.
Read [ Summary Judgment for Lincoln National in Barber v. Lincoln National Life Insurance Company ]

Anthem Refuses to Cover Emergency Room Care After the Fact

Anthem Refuses to Cover Emergency Room Care After the Fact July 18, 2018. By Anne Wallace.
Sacramento, CA Anthem Blue Cross Blue Shield denies emergency room coverage for patients whose symptoms later prove to have been non-life threatening. This has been a long-standing practice, but it is now official policy in six states. Are California patients protected under California insurance law?
Read [ Anthem Refuses to Cover Emergency Room Care After the Fact ]

Court Orders Unum Doctor to Reveal How Much He Was Paid for His Opinion

Court Orders Unum Doctor to Reveal How Much He Was Paid for His Opinion July 17, 2018. By Lori Prapas.
New Orleans, LA Unum Group has come under scrutiny yet again for alleged deceptive practices. This time the insurance giant has lost a battle in the Wittmann v. Unum Life Insurance Co. litigation. Plaintiff attorney Anne Wittmann, who alleges that she was wrongfully denied disability benefits, subpoenaed financial records from James H. Bress, M.D., who Unum hired to review her claim. Unum Group fought back, by moving to quash the subpoena. On July 11, 2018, a Federal District Judge in Louisiana Ordered that the records be turned over so Plaintiffs can ascertain whether his opinion was swayed by a financial dependence on the insurance carrier.
Read [ Court Orders Unum Doctor to Reveal How Much He Was Paid for His Opinion ]

Surveillance Sinks Liberty Mutual Long Term Denied Disability Lawsuits

Surveillance Sinks Liberty Mutual Long Term Denied Disability Lawsuits July 12, 2018. By Anne Wallace.
Boston, MA Fifty minutes and fifty-eight seconds of video showed Donna Cusson walking her dog, shopping, and eating in a restaurant. That was enough to doom her long term denied disability lawsuit against Liberty Mutual. It is an eight-year old case, so some things have changed -- not the fact of surveillance in LTD cases, though. And now it’s not just video tape that LTD claimants have to worry about.
Read [ Surveillance Sinks Liberty Mutual Long Term Denied Disability Lawsuits ]

MetLife Refuses to Disclose Background Claim Processing Principles

MetLife Refuses to Disclose Background Claim Processing Principles June 28, 2018. By Anne Wallace.
Jacksonville, FL: On April, 20, 2018, the United States District Court for the Middle District of Florida denied a Metropolitan Life benefit claimant the right to see the company’s internal claim processing guidelines. Perera v. Metropolitan Life Insurance Company actually relates to death benefits, but it relies heavily on an earlier decision in a long term denied disability lawsuit against MetLife.
Read [ MetLife Refuses to Disclose Background Claim Processing Principles ]

Big Law Employee Sues Unum Group for Denial of Benefits

Big Law Employee Sues Unum Group for Denial of Benefits June 22, 2018. By Lori Prapas.
Greeneville, TN: On May 14, 2018, Janet Mitchell, a former employee of the mega law firm Jones Day, filed a lawsuit against both Unum and Jones Day in a Tennessee Federal Court. Mitchell states that she suffers from a constellation of health conditions that prevent her from being able to work, including coronary artery disease, fibromyalgia, osteoarthritis, hypertension, and chronic obstructive pulmonary disease. She alleges that Unum denied her claim for long-term disability benefits even though several of her treating physicians provided Unum with medical reports supporting her claim. Yet Unum denied her claim without ever having one of its own physicians examine her. The lawsuit says the denial was issued in bad faith, in order for Unum Provident to meet its monthly target.
Read [ Big Law Employee Sues Unum Group for Denial of Benefits ]

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