In Spite of Recent Accolades, Unum Continues to Be Criticized


. By Gordon Gibb

Anyone who thinks of the insurance industry, and Unum in particular, as having a Jekyll and Hyde personality can be forgiven in light of recent events and allegations both supporting and decrying the company. In recent years Unum Insurance has been battling a reputation of unfairness to its policyholders by way of alleged inappropriateness of denials to legitimate claims.

But all that will be far from anyone's thoughts on November 10th when the Southeastern Chapter of the Association of Fundraising Professionals recognizes Unum Insurance, among others, at a public luncheon being held at the insurer's home base in Chattanooga.

Specifically, the insurance juggernaut will be one of two recipients of the Associations' "Corporate Philanthropists of the Year" award. According to the Chattanooga Times Free Press, Unum is being recognized for donating millions of dollars and volunteer hours to schools, food banks, education, the arts, as well as health and wellness projects.

In recent months the insurer has been feted as being a valued employer by its employees and has captured numerous industry awards.

And yet, former Unum Provident employee Linda Nee continues to hammer the insurer in her blog. On Monday, Nee took the insurer to task for its practice of hiring board-certified physicians to guide Unum in the analysis of claims.

To be fair, Nee pointed out that while other well-known insurers use less-expensive, "outsourced" medical opinions, Unum "spends an incredible amount of money purchasing 'Board Certified' physician credentials in order to lend credibility to the documented opinions they write" with regard to Unum disability, Nee says.

However, are the opinions of physicians on the Unum payroll biased? Nee, who was employed at Unum until 2002, feels that practices she witnessed at the time are likely still a factor.

"Back in 2002 while still an employee of Unum, it was clear 'walk-in' physicians and nurses received a great deal of pressure from the Medical Director to document claims supporting denials rather than approvals" with regard to claims for Unum long-term disability insurance, Nee writes. "One newly hired Cardiologist started by documenting claims fairly, only to be placed on probation until his 'stats' improved. He quickly got the idea though that in order to keep his job he had to subscribe to Unum's strategies to deny legitimate claims."

Nee also notes that "at least up until 2002," physicians directly employed by First Unum participated in an entity called the Management Incentive Compensation Program (MICP), "which provided its physicians and exempt management staff the opportunity of receiving up to 30 percent of their annual salary in incentives if they supported the company's claims strategies resulting in increased profits."

It is unclear if the MICP program still exists today, Nee says. However, in Nee's view "Unum's physicians are handsomely paid between $100,000 to $200,000 plus incentive to sit in an office, review files and author reports in favor of Unum's claims protocols" regarding Unum disability insurance


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