UNUM Paul Revere Long Term Disability Policy Denials – Shifting the Burden Of Claims Investigation
The Ninth Circuit in Hangarter v. Provident Life An Accident Insurance Company, 373f.3d998, 1014 (9th Circuit 2004) entered a skating decision summarizing the extensive evidence that had been developed in a jury trial that resulted in the punitive verdict of over $10 million against UNUM Provident and Paul Revere based on a claims handling.
It was confirmed during this case that UNUM Provident and Paul Revere had a practice of shifting the burden of “claim’s investigation to the insured.”
A Long Term Disability carrier should be conducting a reasonable investigation of all the relevant information in a Long Term Disability claim, evaluate that evidence in a non-adversarial fashion, use unbiased experts in evaluating a claim and assist every Long Term Disability applicant with the claim.
Despite the existence of these “undisputed obligations that exist in the handling” of Long Term Disability claims, the court in Hangarter found that UNUM Provident and Paul Revere had instructed “their employees that it was the Long Term Disability policies obligation to prove the claim.” The Court went on to find that UNUM Provident and Paul Revere had used “in house medical personnel engaged in cherry picking records to find grounds for denying claims regardless of their actual merit.”
In a telling commentary the Ninth circuit found that the in house medical personnel “focused upon any apparent inconsistency in the medical records, whether information supplied by the claimants, rather than an attempt to derive a thorough understanding of the claimant’s medical condition.”
Further, the court noted that UNUM Provident had a “practice of piece-mealing claimant’s medical conditions and did not consider the totality of the medical circumstances.”
Unfortunately, despite the fact that that decision was entered in 2004, it remains Provident Life and UNUM and Paul Revere’s practice to use in house personnel to cherry pick your medical records, look for inconsistencies in the medical records and the information that you’ve supplied and piece-meal your medical condition without considering the totality of all of your disabling conditions.
If you are a UNUM Provident Paul Revere Long Term Disability policyholder whose benefits have been denied as a result of cherry picking or ignoring the totality of your medical condition, immediately call your UNUM Provident Paul Revere Long Term Disability benefits attorney Nancy Cavey.
Tampa Bay based Long Term Disability attorney Nancy Cavey can help you perfect your Paul Revere UNUM Provident Long Term Disability claim.