
A Maryland radiologist is suing Unum, the leading writer of insurance disability claims, for breach of contract and insurance claim denial after the nationwide insurance company abruptly cut off her disability benefits without warning.
Dr. Janis K. of Lutherville, Md. had four separate Unum disability insurance policies at the time she became disabled in June 2011, according to her disability insurance lawsuit. Unum initially paid Janis, but on Oct. 25, 2012, it ceased payments.
She appealed the decision and lost. Unum immediately closed the claim file without providing her the opportunity to provide sufficient evidence, including information from her treating physicians, according to the Unum lawsuit.
Thousands of consumers have filed Unum lawsuits for unfairly denying or wrongfully terminating legitimate disability insurance claims to boost company profits. Unum has long been accused of making disability insurance claim denials to boost its bottom line.
In addition to thousands of individual claim denial lawsuits, the company’s practices have resulted in a multi-state investigation into Unum — formerly UnumProvident — as well as an Unum/UnumProvident class action lawsuit investigation to research all claims of Unum benefit denials. Unum has been reprimanded for refusing to consider the medical opinions of outside physicians, something a court found to be illegal.
In 2004, Unum entered into a regulatory settlement agreement with insurance regulators in more than 40 states related to Unum’s handling of disability claims. Part of the settlement required Unum to implement revisions to claim procedures and provide for a full re-examination of both reassessed claims and disability insurance claim decisions after the January 2005 effective date of the agreement.
In 2008, the Massachusetts Division of Insurance, one of three lead state regulators in a multi-state examination of the Unum Group’s handling of disability claims, announced that Unum had completed a mandated claims reassessment process and returned more than $13 million to Massachusetts consumers.
“More than 40 percent of the reviewed claims were reversed in whole or in part, resulting in a total of $676 million in additional benefits for consumers in every state and the District of Columbia,” according to a news release.
“Thousands of consumers who filed worthy disability insurance claims in Massachusetts and across the country will now receive the benefits they rightfully deserve,” said Insurance Commissioner Nonnie S. Burnes. “I am pleased that Unum Group has complied with the requirements of the Regulatory Settlement Agreement and has instituted policies and procedures to ensure its claimants are treated fairly going forward.”
Unum and its subsidiaries, Provident Life, The Paul Revere Life Insurance Company and Colonial Life & Accident Insurance Company, have all been accused of unlawfully denying disability insurance claims.
Unum has been accused of doing things like changing policies after claims are filed (without the knowledge or consent of policy holders), obtaining opinions from unqualified “experts,” improperly investigating claims, using contract medical examiners to interpret medical records, using third-party medical examiners to deny claims when policyholders did not provide a medical exam, not providing policyholders sufficient time to obtain a medical exam, requiring repeated independent medical examinations, denying a claim without any medical examination and refusing to acknowledge certain disabilities, specifically mental illness, fibromyalgia, and chronic fatigue syndrome.
The company has also been known to tell claimants they fall under a pre-existing condition and pressure claimants to accept a lower settlement.
Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.
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