You have made a wise decision to get more information about UNUM Disability Insurance so you understand before you stop working what you have to prove to get your benefits, how much you will get and how strategic planning can make all the difference.
You must understand the tricks and games disability carriers like Unum make every day to improve their bottom line by denying or terminating benefits. It is not and has never been about being faithful to the promise they make to you when you bought your policy and paid premiums or doing right when you desperately need your disability insurance benefit.
You made a wise decision to get more information from an experienced disability insurance lawyer when Unum issued its denial of your appeals, and are now faced with the need to sue Unum to get your benefits.
Working with an attorney who has been inside the family of a disabled breadwinner and who has had a ringside seat to the personal fight with a disability carrier is the right thing to do.
Remember you only have one chance to get your disability application right, one chance to file a winning appeal and one chance to convince a judge that Unum was wrong!
Unum, once known as Union Mutual, was one of the United States largest disability insurance companies until the recent merger of Liberty Mutual and Lincoln Financial.
Unum has grown over the years as a result of mergers with Provident Life Insurance Company, who pioneered the concept of disability insurance, and the Paul Revere Life Insurance Company. Paul Revere was one of the only sources of disability insurance for medical professionals and had a history of paying claims until its merger with Provident in 1997.
Unum Provident was formed in 1999 as a result of the merger and they adopted the UNUM Group name in 2007.
Unum owns a number of smaller insurance companies that include:
In my opinion, the Paul Revere merger was the beginning of the end of fair claims handling and the newly merged company made a business decision to change the way it handled disability claims.
In Merrick v. Paul Revere Life Insurance Co., Unum Provident Corp, dba Unum Life Ins. Co. of Am. & Provident Life & Accid. Ins. Co., 2008 U.S. Dist. LEXIS 106976 (D.NV. Nov. 1, 2008), the court took judicial notice that the Ninth Circuit had “previously found that evidence exists that these Defendants had a conscious course of conduct firmly grounded in established company policies that disregarded the rights of insureds.”
Every Unum policy holder should read the series of opinions in this case. The court made it clear how pervasive Unum’s institutional bad faith pollutes the claims handling process.
The courts, amazingly, used terms like “a scheme engaged in”, “profits at the expense of insureds”, and “unfair and unlawful claims handling practices” to describe Unum’s conduct.
Unfortunately, nothing has changed since that decision. Unum just tries to hide it conduct better.
Unum was heavily criticized about their profit at all costs model and the “kick it up a notch and get pizza if you deny more claims” contests. It offered adjusters rewards for closing files and favorable employment reviews.
It was sued by 48 states because of its claims handling and denial process and, ultimately, entered into a Multi-State Agreement which provides that it make revisions to the claims handling process.
The result was a temporary correction in Unum’s claims handling process. However, it has, in my opinion, returned to the bad behavior that got it into trouble to begin with. Only now, UNUM knows how to cover its tracks much better. It still uses the old playbook but has dressed it up in a new cover.
Unum is back to playing games with initial applications and making endless and multiple requests for medical, financial and vocational information before it figures out a way to deny benefits. This delay and denial strategy drains the policy holder’s bank accounts as they try to stay financially afloat.
Unum is back to its old tricks by using “liar for hire” doctors who give Unum the ammunition it needs to justify a claims denial or termination. Unum rarely tells a denied policy holder the real reasons the claim was denied. Worse yet, Unum fails to fully explain what the denied policy holder needs to submit to successfully win an appeal.
That’s why it is crucial that you be represented at both the initial application and appeal stages of a Unum claim by an experienced lawyer, like me, who battles Unum daily. Some Unum policy holders make the mistake of going it alone and they pay dearly for “doing it yourself.”
Once the appeals process is exhausted (and that really means you are exhausted by the endless requests for information and battling with Unum), the only recourse is to file a lawsuit. If you purchased your insurance through your employer, the policy is most likely governed by the Employee Retirement Security Act or ERISA.
Despite its name, the ERISA statute and regulations are NOT policy holder friendly. You CANNOT add anything to the claims file after the last denial so all the Federal judge gets to see is what is in Unum’s file. If you didn’t know enough to get the claims file when you appealed, didn’t know enough to add medical, vocational or lay evidence to the file, or didn’t make the right arguments, you have all but destroyed your case.
An appeal of a denied Unum claim is the trial of your case. Of course, you are a very smart person and may have many degrees, but taking on Unum is the job of a specialist. A Federal judge will give Unum the benefit of the doubt because your Unum policy requires you to prove they are wrong and not the other way around. You owe it to yourself and your family to have an experienced disability attorney, like me, take on Unum. After all this is about getting the disability benefits you deserve and you paid for.
Some policy holders have bought their own disability policy through an agent and that is known as an individual disability insurance policy. The game is the same but the playing field is more level because any claims denial can be challenged in state court which is a friendlier place to be if you have to sue Unum.
Don’t think that Unum isn’t playing the claims delay, denial or termination game with individual disability policies. They are, and the policy benefits at stake are high and there is much more to lose if you aren’t represented by a Unum individual disability attorney like Nancy Cavey. After all, you invested hundreds of thousands of dollars in your education and bought the Unum policy to protect your finances and lifestyle.
UNUM, headquartered in Chattanooga, Tennessee, is the United State’s largest provider of employer sponsored group disability benefits “providing benefits for 42% of today’s Fortune 500” businesses. Unfortunately, it is our experience as Florida UNUM Disability Denial lawyers that UNUM does not deliver what it promises to those businesses who purchase group disability insurance for its employees.
UNUM’s website would have you believe that the “focus is on recovery.” Long term disabilty benefits from UNUM “can replace part of your income so you can focus on recovery instead of worrying about your ability to pay the bill.” Unfortunately, as a Florida disability lawyer who represents many UNUM policy holders, my experience is that UNUM typically stops paying short term disability benefits just before the long term disabilty benefits are to start.
Long term disability coverage “provides benefits when you are unable to work for a longer period of time and may last until you are able to work” according to UNUM. Many times UNUM will have the file reviewed by a nurse or “independent doctor” paid by UNUM who will say you can work despite what your doctor says about you inability to work. UNUM will deny long term disability claims for 3 primary reasons:
(1) There is no “objective evidence of your diagnosis” despite testing or your doctor’s findings on examination.
(2) There is no “objective evidence of your disability” despite physical findings of disability and pain.
(3) “No relationship between your medical condition and your inability to work” despite the fact that your employer has terminated you, you can’t function at a sedenatry work level, or that you are getting Social Security Disability benefits.
If you are insured by UNUM and are thinking about applying for short or long term disability benefits or have been denied disability benefits by UNUM, get in touch with an experienced attorney. Florida UNUM Disability Denial lawyer, Nancy Cavey, has written “Robbed of Your Peace of Mind”, a must read about the policy terms you don’t want to see in your UNUM disability policy and the mistakes you can make in your UNUM long term disability claim.
Order your no-obligation copy immediately. Answering these broad-based questions isn’t easy. Help is a phone call away. You can contact Nancy Cavey, an experienced long-term disability attorney at 727-894-3188.
The type of policy that you have will determine your rights and whether you are playing on a level playing field. UNUM offers:
Click on the link above for an explanation of each and how it works with your situation. Call us with any questions you may have regarding your UNUM disability insurance claim. We help nationwide at 727-894-3188. The consultation is free.