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Unum Can't Translate its own Policies

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San Francisco, CARichard bought an Unum health insurance policy back in the 1980s, which included Unum long term disability, and he never missed a payment. The Unum (also known as Unum Provident) policy Richard bought insured that he could receive benefits if he was unable to work in his specific profession—something akin to a ballerina taking out an insurance policy on her legs.

Depression DisabilityRichard's job as an executive search consultant (also known as head-hunter) for hi-tech companies was taking its toll. He was president and CEO of the third largest search firm in San Francisco and had 19 staff—the stress was too much and he was diagnosed with chronic depression.

"I wasn't able to perform in my world of executive search, so my doctor put me on disability," says Richard (not his real name pending a lawsuit). "After a waiting period of 30 days, I received my first benefits check from Unum, in October of 2001. I followed up each month with a monthly report from my doctor but it wasn't long afterward that they began to hound me…

Unum Provident continually pressured me to return to work. Sure I could work but in what capacity—as a busboy? The insurance company sent me to an educational facility to determine what other kind of work I could do. They continually ignored the fact that my policy was specifically targeted toward my profession.

They threatened to discontinue payments and their next tactic was the 'independent medical examiner (IME). These IMEs are supposed to be unbiased but they had a preconceived notion that I was a fraud or faking it somehow.

My doctor had recommended that I get out more—become more sociable and exercise. This chronic depression caused me to go into a reclusive state and avoid everything. Then, upon my doctor's advice, I became an exercise addict and went out dancing at night. I got really healthy and of course Unum's IMEs translated that to mean I could go back to work. They didn't even know what I had done for a living, nor did they ask.

Every time I did something healthy I would be punished by the insurance company. My doctor wrote scathing letters to Unum, telling them how they were impacting my mental and emotional health by using these IME assessments against me and denying my disability.

It's not like I didn't want to work; several times I tried but it was unsuccessful. I have been my own boss for 30 years so it was difficult, to say the least. These assessments said I could be a bartender or mechanic, but what had that to do with me? My policy clearly states that if and when I return to work, and due to my disability I am unable to receive the same kind of income that I got before, the policy would subsidize my income.

Unum Provident didn't acknowledge their own policy.

And dealing with Unum was a fulltime job, it was emotionally draining. Unum cut me off a few times; the last time was March of 2008. Prior to that they stopped paying my benefits for 6 months. And a few months here and there missed. In other words, my disability checks were never stable and regular.

I had spent a lot of money to keep this policy and now I found myself forced out of my home, I had a divorce and I also filed for bankruptcy. If Unum was regular in their payments and more supportive, this could have been prevented.

My 401K, my retirement money and Unum life insurance--which I borrowed against—was all gone. Having lived in a world where I made $200,000 and now having nothing fed into my depression.

Unum sent me to more IMEs, including a forensic psychologist. They wanted to find a way to deny my benefits and they succeeded. The IMEs didn't deny that I was depressed but said I needed therapy to get back into my profession. Or I could work at another career (busboy, bartender?). BUT my policy says I have to find work in my profession.

Next up, I got the California State Insurance Commission involved and I was reinstated. (Interestingly, Unum has been threatened to be thrown out of California many times because of their continual bad faith practices.) I got 6 months retroactive benefits, about $50,000.

Then I got sent to IMEs again and my benefits were denied again. Unum doesn't give you any lead time, there are no warnings that you have been denied benefits; one day a letter comes in the mail instead of the monthly check.

Since last March I have been living on social security and mooching off my girlfriend. I have exhausted the appeals process so now I am getting legal help—an attorney contacted me through LawyersandSettlements and he is in the process of filing a lawsuit against Unum Provident."

Richard is going to keep LawyersandSettlments posted regarding his lawsuit…

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READER COMMENTS

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Was this case ever resolved? I am in a similar situation

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Dealing with Unum now....

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