The Domino Effect of Unum Claim Denial

New York, NYThe need for any insurer, including Unum, to verify claims by policyholders is a given in view of the reality that there are those who attempt to take their insurance company to the cleaners. However, Unum insurance appears to have a reputation for denying legitimate claims that not only prove a hardship for the claimant—they can also prove to be a distinct disadvantage for others.

As evidenced by Linda Nee's blog entry of February 15, there are times when Unum denies a justified benefits claim that poses a risk to public safety—especially if the work normally performed by an Unum claimant (since denied) is sensitive, exact, specialized and exposes the compromised claimant to a lot of innocent people.

Nee, a former Unum employee, gives examples of various Unum clients who ultimately suffered a denial of their Unum disability claims and were forced back to work.

Nee tells the story of a radiologist based in New York who suffered the removal of a diseased eye. After two years of attempting to read X-rays with one good eye and having to contend with a change in technology (lighted computer screens), the Unum client filed a disability claim with his insurer. Given his ongoing difficulty in reading the X-rays and concerned with his capacity to translate them accurately, he felt his claim against his Unum disability insurance police was justified.

However, after 18 months of payments, Unum is reported to have denied his claim, indicating that he should be able to perform his job with one good eye. Forced to return to work, the technician was found to mis-read several X-rays while in surgery, posing a significant risk to the patient. His colleagues, Nee says, sent him home.

Then there is the story of a dentist and Unum insurance client who was injured in an automobile accident, leaving him with a serious cervical disc issue. The restricted range of motion he experienced as a result, left him unable to stand over his patients for extended periods of time (required by a dentist), and he had trouble seeing inside his patients' mouths for certain dental procedures. Dropping to part-time status didn't help.

The bottom line is that the dentist could no longer safely work as a dentist.

He submitted a claim to Unum Group. His claim was denied, with his insurer insisting he was capable of working full time with the necessary therapy and treatment. Sadly, Nee reports, the dentist was working with a drill inside a patient's mouth several weeks after his Unum disability claim was denied, when the drill slipped and the dentist put a hole into his patient's jaw.

Nee's point is a systematic denial of legitimate claims by the former Unum Provident not only serves as a hardship to claimants, it could also reach much farther and impact the lives of innocent people when the compromised Unum long term disability insurance client is forced to continue working when it may not be safe to do so.