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Disability Claimant Angry That Her Policy Is Now with "Sleazy and Shady" Unum

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Chicago, ILBertha was angry, to say the least, when John Hancock, her health insurance carrier of 25 years, informed her that Unum (formerly UnumProvident, and now notoriously denying disability benefits to policy holders in the role of "agent") now holds her policy.

"I wish insurance companies like John Hancock would be honest with their customers," says Bertha. "It is like false advertising. After all these years of dealing with a Grade A company like John Hancock and now you find they turned their processing over to some sleazy, shady company like Unum.

(Besides selling policies through a number of subsidiary companies such as Provident Life and Accident Insurance Company, The Paul Revere Life Insurance Company [Paul Revere Life] and Colonial Life & Accident Insurance Company [Colonial], Unum is also the agent handling claims under MetLife [Metropolitan Life], John Hancock, New England Life, and Equitable Insurance policies. Now Bertha must apply and subsequently appeal to Unum rather than John Hancock for disability benefits.)

Last March, Bertha had a bad case of vertigo, high blood pressure and other medical issues. "My doctor prescribed extensive rest so I applied for long-term disability benefits," Bertha explains. "It took Unum six months to assess my claim before they decided that I wasn't sick enough!"

Then came the usual Unum runaround. First they told Bertha she couldn't apply for benefits because she hadn't filed her 2010 taxes. "I wrote them back a very angry letter," she says. "I had all my W2 forms—my annual statement of wages. They wanted to know if I worked and if I was no longer able to work. I own a multi-unit building, and I live in one part and rent the other part. Unum said that if I had other sources of income, such as my rental property, that would affect my chances of getting disability. They considered it a business. But that is not my occupation. Regardless, if I have income from renting my house that is not their concern."

Then they decided that Bertha wasn't sick enough. "Unum kept asking me for more medical information, and in the end, they said they talked to someone at my former job and that person said I wasn't sick," says Bertha. "Unum told me who this person was and I told them that she wasn't my supervisor or a medical specialist, so how could she determine if I was sick?"

It gets even more incredulous. Bertha never did see one of Unum's independent medical examiners to determine that she was sick, but they did send a private investigator to her home. "This investigator asked what kind of work I did and what kind of activities I did every day," she says. "And I had to verify my education: I have an executive policy which ensures my ability to do my job but not a lesser or lower job. I must be able to work in my field—I am an education administrator.

"I told him that this position is stressful. I work long hours, and I have a staff of about 12 educators and I am also a grant writer—these are the kinds of things I do on a daily basis. I used to work about 50 hours per week. As for activities, my job requires a lot of writing, direct supervision and meeting lots of people, from educators to parents to students to high school administrators. You could say my job is in a niche market and I have been doing it for about 30 years. I was good at what I did, and I was also a workaholic.

"As for what I can do now, I told this private investigator that I rest a lot, try to work on my house, read a lot, and visit family and friends. I now lead a sedentary lifestyle.

"Since I was denied benefits, my medical issues have changed. I have been diagnosed with mini-strokes, which is related to my high blood pressure, and I was recently diagnosed with diabetes. And now my doctor believes the vertigo was also a stroke. If Unum tells me I am not sick enough this time, do you have to be on your deathbed to qualify for benefits?

"I recently hired a lawyer who told me to apply for my social security disability benefits, and when I get that, it will only be more ammunition to get my benefits from Unum. If social security deems me as disabled and Unum still rejects my claim, then Unum will have another lawsuit to deal with.

"Because my policy is so old, if I get social security, Unum cannot offset my benefits. This means that I should be able to collect from both social security and Unum. So that is my next battle: my attorney has advised me to sue Unum if I don't win my appeal. He is working on a contingency basis, and has advised that we go after both John Hancock and Unum. Fine with me."

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