More than a decade ago Dateline NBC targeted the insurance giant Unum. There were numerous complaints that the company was wrongly denying people who had disability insurance policies safeguarding them in worst case scenarios, such as when they became permanently disabled or too ill to work.

Since then, many Unum claim denial victims have come forward and filed lawsuits against the company, accusing Unum of breaking its contract with policyholders by denying their insurance claims in bad faith. Multiple Unum class action lawsuits have also been filed.

Correspondent John Larson sat down with one policyholder, John Montana, to discuss his struggles with Unum. In February 1998, Montana (a car salesman) was driving on a New Mexico highway when he had to swerve to avoid massive rocks blocking the lane. He ended up trapped upside down in the car. He recalls, “The nurses and all the physicians were saying, ‘Do you have any feeling? Can you move your legs?’ And I kept telling them, ‘I can’t feeling anything from the chest down.” The accident had severed his spinal cord. Montana thought that at least he had his coverage from Unum, but he hadn’t a clue what was in store for him.

Today, Montana has some limited arm usage, but he’s medically a quadriplegic and is paralyzed for life. He was no longer able to support his family or work. However, he had been paying into his Unum policy at $59 per month for disability coverage. He filed a claim with Unum and began receiving payments, but two years later he was informed his benefits would stop. “I was scared, I was frightened. I go, ‘Well, there’s got to be a mistake.’” Unum declared that even though Montana was paralyzed, he no longer qualified for benefits. The company claimed it has a “surveillance tape” that showed Montana had miraculously “improved immensely” and was capable of working as a car salesman again. Montana’s doctor, Jonathan Burg, says “There’s no way” Montana is faking his serious disability. John Larson asked Montana if he offered to take tests for Unum and Montana said yes. “And so did they do that? Did they evaluate you?” Montana says he never heard back from them.

Prior to the Unum lawsuits and Unum class action lawsuits that have been filed, the company says it dealt with $1.5 billion in fraudulent claims every year so it began cracking down. Unum did give the surveillance tape to Dr. Burg, but the doctor says it showed “nothing new” about his disability, although there was evidence of Montana somewhat using his arm, which was always considered “limited usage” after the accident. “By all standards, this man is completely and totally disabled.” Montana uses a specially equipped van designed for quadriplegics. He began to consider bankruptcy and his wife divorced him. However, he still has children to support and started to worry about losing his home. Montana says he became suicidal. Unfortunately, his scenario isn’t unique.

In the Dateline special, three former Unum employees discussed what they call unfair practices, claiming the company is “obsessed” with denying policyholders. “They have to literally fight to get their benefits,” said one. Larson asked, “Did you feel pressure to close claims?” and the employees responded with an “absolutely.” They only spoke to the media outlet if promised anonymity, afraid of reprisals. One said, “They even gave incentives, incentives for closing claims. If we projected that we were going to close 30, if we get to those 30, we’ll have a pizza party or we’ll have an ice cream party.”

Unnerving Business Practices

Since the expose, hundreds more have come forward with their own Unum complaints. In 1993, according to the Unum lawsuit, the company was losing millions but then new management came into the picture and things changed; Unum started making millions. One of Unum’s own physicians, Dr. William Feist, left the company two years after the new management took over, saying, “There was no concern for the individual. It was just bottom line. If we can terminate this file, we’re going to do it.” He says Unum targeted those who were costing the company the most money, and this was decided at “roundtables” where he says, “The object of the roundtable was to cut off the high dollar claims.”

When Dateline was set to air, it’s alleged that Unum encouraged Larson to not believe Dr. Feist. They claim these roundtables never took place as Dr. Feist says, but the former employees sided with the doctor. According to the former workers, Unum urged employees to focus on diseases that didn’t show up on tangible tests, such as Parkinson’s, mental illness or migraines. “So they’re fatigued. Prove it.”