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Insurance Denials

Worcester, PA: (Apr-16-08) A lawsuit was brought against Unum Group, the nation's leading disability insurer, over issues pertaining to its claims handling and denial of claims to more than 250,000 policyholders. Records indicate that a settlement had been reached in the case in 2004, after individual investigations were launched by regulators in MA, ME and TN, the three states in which the company has principal operations. Sources stated that investigations into the company's trade practices were also being carried out by the US Department of Labor and New York regulators.

In a recent announcement, Unum Group spokespersons stated that the company has agreed to pay $676 million in additional benefits to more than 9,500 policyholders. As per the terms of the deal, approximately 184 policyholders in MA will receive $13.6 million. Under the terms of the agreement, the company incurred a $127 million pretax charge, including a $15 million fine.

The earlier investigations by the federal authorities recorded that the company did not violate any laws or regulations but operated a corporate culture in which policyholders were confronted with an unfair burden in justifying their eligibility for benefits. Unum Chief Executive Officer Thomas R. Watjen claimed that the disability insurance company has revised its claims handling and reassessed its denial of claims procedures, and is a better company as a result of the agreement and resulting review process. Federal officials said that the company complied with all of the requirements outlined in the agreement and as a result, did not incur any additional penalties. [WORCESTER TELEGRAM: UNUM AGREES TO PAY $676 M]


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Published on Apr-18-08


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