Unum is the largest and oldest insurance company in America, providing disability insurance to approximately 17 million Americans. However, the company allegedly routinely wrongfully denies disability claims.

Unum was the subject of a “60 Minutes” television special on CBS, observing the alleged disability insurance claim denial practices and tactics of the insurance company.

The television special featured several anonymous Unum representatives, who detailed the system Unum has set up for claim denial, and the incentives they give their representatives to meet a certain quota of claim denials.

According to experts, Unum and several other major insurance companies had begun signing policyholders onto premium plans between the 1970s to 1980s, with the intention that the policyholders would pay the higher monthly payments to maintain them.

Unfortunately, the market crashed and customers could not make the payments, causing major fiscal damage to the insurance companies. Due to this setback, these insurance companies have allegedly formulated different systems to deny certain claims, which often includes claims of mental illness and non-life threatening situations.

Unum has been facing wrongful claim denial lawsuits since about 1992, which have been filed by claimants who filed for long-term or short-term disability coverage, but were allegedly wrongfully denied.

In each of these Unum claim denial lawsuits, the plaintiff would allege that Unum had wrongfully denied his or her disability claim without just cause, and ignore all medically relevant documents or it would changing certain facts on the claim to justify the claim denial.

Examples of claim denial tactics Unum has allegedly used over the years include, but aren’t limited to:

• Changing policies after claims are filed and failing to notify policyholder of the changes
• Improperly investigating the claim and obtaining opinions from unqualified third party opinions
• Misreading medical records by different people, often by independent medical examiners
• Repeatedly demanding requests of different medical records or denying a claim without any medical examination
• Refusing to acknowledge the policyholder’s disability, especially mental disorders
• Trying to claim the condition is preexisting
• Repeatedly denying a claim with the intent to wear down the policyholder to a lower settlement
• Partially paying a claim for total disability
• Attempting to use detectives, friends, co-workers or neighbors to discredit the disability

Overview of Unum Allegations

Legal experts state that Unum is more likely to deny on long-term disability claim, compared to a short-term one, because of the difference in payout. Unum’s practices have reportedly become so bad, that employees have been fired for complaining to management about the unfair claim denials.

In 2005, the Department of Labor launched an investigation into Unum’s practices and demanded that the company cease its unfair claim denial tactics. The government stated that the company needed to make the decision of approving or denying a claim, based on its merit rather than the amount of money the company may have to pay.

Additionally, the Labor Department also ordered Unum to stop using third-party opinions to deny and obstruct claims and to stop prolonging the claim submission process.

Other claims against Unum involve forcing policyholders to apply for Social Security, despite knowing that it would make the claimants ineligible for benefits according to their policies.

The company had allegedly threatened these policyholders with severe pay reduction of benefit payments and deliberately clogged the Social Security Administration with ineligible disability claims.