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After a Dozen Years, Unum Insurance Lawsuit Finally Settled

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Minneapolis, MNAn Unum long-term disability insurance case involving a complaint over unpaid benefits dating back 14 years appears to finally be resolved. According to a recent issue of Leagle Inc., the dispute was between Unum and a urologist who claimed he could no longer perform the duties necessary to his profession.

The plaintiff in the matter submitted a claim to Unum in 1996, identifying himself as a "Urologic Surgeon-Urologist" and a long-term disability policyholder with Unum. Due to ankle pain that prevented him from standing for long periods, the plaintiff was no longer able to perform open urologic surgeries. He submitted a claim for total disability, which Unum denied.

The urologist sued.

After winding its way through the courts for some years, a jury at trial finally concluded that the plaintiff was entitled to residual disability benefits exceeding one million dollars for the period between October 1, 1996 and December 1, 2004. The amount—$1,006.380—was reduced by $114,000 and a figure that represented, in the jury's view, funds that had already been paid.

The plaintiff, however, disputed the amount representing $114,000. It was later found that the jury had erred, based on the incorrect belief that the defendant had already paid that amount prior to terminating the surgeon's benefits. However, it was later found that the amount paid was actually $83,474—a figure later subtracted from the full jury award.

The amount of disability benefits owed was adjusted to $922,906. The Court subsequently added $47,358.15 to the final tally based on a "waiver of premium" benefit contained in the policy, representing the time period that the jury concluded the plaintiff was disabled under the terms of the Unum long-term disability policy.

The plaintiff was further awarded prejudgment interest in the amount of $498,340 on his residual disability claim, together with a further $28,810 representing the return of premium benefits.

Various motions asking for a new trial and a declaration of a mistrial were denied.

Unum has been swimming against a tide of discontent over several years of alleged misdeeds surrounding a systematic denial of legitimate claims, in an apparent effort to cut costs and increase performance values for shareholders. Various media and former employees have reported numerous examples of bad faith practices when dealing with claimants who maintained their Unum insurance policies in good faith, only to be stiffed when it came time to collect under the stated provisions of the policy.

Unum continues to develop and grow its business and was recognized as recently as June 14 by the National Business Group on Health for its commitment to promoting a healthy workplace and encouraging its workers and families to support and maintain healthy lifestyles. However, it is not known if Unum continues to pursue unsavory tactics as in previous times.

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READER COMMENTS

Posted by

on
I was employed for roughly 5-6 months in voluntary benefits. This included Critical Illness, Accident, Short-Term Disability, Health Screening, etc. From what I can gather, the accident product is relatively new. It seems it's somewhat of a cover - to offer a product in which its policy owners are nearly guaranteed payment. The problem is, the average dollar amount awarded per claim that I processed was $100-$300. A few claims would climb up to several thousands, but overall it was to supplement co-pays, deductibles, etc. After a few weeks, I began to start to piece together some of the practices for the Short-Term Disability claims. As it turns out, they still have a quota to meet on denying claims - or at least an expectation, which I believe is 3 a week. It certainly seems that if this goal cannot be met by a VB STD specialist, he or she would likely lose his or her job. In my time there, I had heard plenty of anecdotes on legitimately deniable claims (pre-ex, elimination period), but there is no doubt in my mind that legitimate claims have to be denied at some point. All-in-all, there were a handful of us that got the boot in a company that's desperately attempting to salvage what's left of its reputation, and doing so by patching wounds with band-aids while convincing everyone it's top-notch care. I'm certain the company has taken every step to cross the line back to legal ground, but they're doing the absolute minimum and operating dishonestly. It's easier said than done, but if they don't want to pay out in high-risk industries, they shouldn't accept the premiums,

Posted by

on
Mr. Halley,
With all due respect I detect cynicism and depression. A friend has been battling this company for years and has been experiencing the very same problems that have been reported here and elsewhere.
Can I make a suggestion? If you are not disabled and therefore not experiencing what these people have/are going through then shut up you ignoramus. However, if you are and have dealings with Unum, you too would understand what this is about. If you do and have not had the testicular fortitude to stand up for yourself and your rights then I feel sorry for you and again sit down and shut the hell up, but don't you dare bash those who have the guts to stand up and fight evil while risking everything. So, I refer you to a couple of lines in the movie "A Few Good Men" that you either pick up your rifle and stand your post or just say thank you...".

Posted by

on
Unfortunately, John Halley's comment comes from a place of extreme ignorance. Just Google "UNUM lawsuits." I just had a claim denied by UNUM Friday. I have already been fighting with this horrible company for two years. I guess I have been doubly "screwed over," as Mr. Halley so crassly puts it--I've been paying the high premiums resulting from the company's numerous lawsuits, and now I'm not being paid for a legitimate claim. I don't know why I was the least bit surprised to find that the problems I have experienced--"losing" documents from both me and my doctors, complicated forms, additional forms sent to my doctors as a delay tactic, lying about speaking to my doctors, etc.--are par for the course. Don't take my word for it. But I guess I'm just another "little guy" so who cares, right? I'm going to go bankrupt before this whole thing is over, and I did everything right. Shame on you, Mr. Halley! Do your homework next time before you post an ignorant comment.

Posted by

on
Another lawsuit won against "the big bad insurance company" -- in this case, UNUM. And we all feeel great for the "little guy" because he won. What we forget is that in the end, everyone else with a policy with UNUM are the ones who get screwed over, since eventually, UNUM just raises the premiums to cover their financial losses. So just think before the next time you are ready to cheer for the underdog.

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