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

August 14, 2018, 7:00AM. By Jane Mundy

Unum seemingly has another bad faith tactic to dispute its claimants’ disability benefits-–or is it a scam?

Santa Clara, CAAs 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.

Nee worked for Unum from 1994–2002 as the VP of compensation, but in reality her job was to terminate and deny long-term disability claims. She thinks Unum has crossed the line more than any other insurance company, and Unum is the only company that has been fined significantly. The multi-million dollar settlement in 2003-2004 also required Unum to reassess 250,000 claims. But did Unum reassess all of those claims? Nee believes that only about 60 percent of the claims were reversed, so for 40 percent of denied claimants, the reassessment process didn't turn out well. And since that time, Unum has found other ways to dispute, deny or “nickel and dime” its claimants.

Unum and Lucens

Unum has hired a company called Lucens -- its third-party paper chaser – to hunt down every nickel and dime associated with SSDI with the goal to collect overpayments from claimants, but such overpayments are always calculated at $696, the same for everyone. This is how it works, according to Nee.

Lucens harasses mostly claimants who have been paid benefits for a long time, or even those with closed claims. The claimant signs a document from Lucens that looks like it comes from Social Security, so Unum can look for increases in SSDI benefits due to additional income, miscalculations of SSDI offsets, retirement income that was never offset, workers’ compensation omissions etc. Next up, the claimant gets a bill from Unum for $696 in overpayment, without any calculations, spreadsheet or any proof whatsoever to justify this amount.

“Unum does not have the authority to arbitrarily calculate an overpayment and offset or reduce benefits to $0 without first showing calculations and proving to the claimants’ satisfaction that amounts alleged are actually due,” says Nee. “Unum simply calculates the overpayment and then offsets from benefits.”

Unum Deception

So, how did Unum come up with $696? Nee says it is an ingenious psychological plan on Unum’s part. For instance, one of her clients owed Unum $5,000 in overpayments but Unum sent her a bill for- you guessed it-- $696. Claimants are happy to pay the $696 alleged overpayment rather than five thousand dollars alleged, and no questions asked. “Of those client claims I’ve actually investigated and calculated myself I found overwhelmingly large numbers of claims where Unum’s figures for pre-disability earnings and indexing were grossly inaccurate,” adds Nee.

If you received a $696 overpayment bill from Unum, Nee advises claimants to do a few recalculations themselves to determine whether they’ve been paid correctly elsewhere in the policy. “It might be possible that Unum owes you and not the other way around, even subtracting the $696 alleged due by Unum,” says Nee. “The process of “forgiving” alleged overpayments except for $696 for everyone is deceptive particularly when Unum never has to show calculations or prove what’s owed, and people are enticed to pay the lesser amount in lieu of what’s actually owed.” Like being between a rock and a hard place.

As well, a claimant is under no obligation to even provide their social security information to Lucens. Maybe there is no overpayment at all – maybe it’s all a scam! So how does Unum get away with this? Nee says that no one is watching Unum.

Linda Nee is a Licensed Maine Life and Health Consultant with a specialty in management of disability income and employer ERISA claims. As a former Unum Life Insurance and UnumProvident employee, Linda now owns and operates Disability Claims Solutions, providing insureds with disability claim consulting services.