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UnumProvident Must Reopen All Long Term Disability Claim Denials from 1997 to the Present!

On November 30, 2004, UNUMProvident reached a tentative settlement with State Insurance Regulators, which required UNUM, and its subsidiaries, Paul Revere Life and Provident Life & Accident to reconsider more than 200,000 long term disability claims which had been terminated or denied from January 1, 1997 to the present. This settlement is intended to resolve issues raised by insurance regulators concerning UNUM's claims handling practices. These investigations focused on assertions that UNUM and its subsidiaries had improperly denied claims for benefits under individual and group long-term disability insurance policies. They concluded that UNUM had committed numerous violations of its obligation to fairly administer claims.

The settlement requires UNUMProvident Companies to:

  • Reassess approximately 200,000 claims that previously had been terminated or denied.
  • Restructure their claim handling procedures to ensure objectivity and fairness.
  • Pay a $15 million fine.

The settlement agreement gives thousands of current and former UNUMProvident Companies' policyholders an opportunity to have their terminated or denied claims reassessed.

Under the settlement agreement, the majority of persons whose claims for group or individual long-term disability benefits were either terminated or denied after January 1, 2000, will receive notice via mail of their right to have their claim reassessed.

Persons whose individual or group disability claims were denied prior to January 1, 2000, although not receiving notice directly from UNUM, will also be able to request to have their claims reviewed by applying to their specific UNUMProvident Company.

In addition, any individual whose claim has been terminated or cut short after two years based on an assertion that their disability was a mental and nervous condition rather than a physical condition, can apply to have their case reopened.

UNUMProvident officials estimate that the settlement will cost them over $100 million in restitution to policyholders making claims. If UNUM fails to implement the required changes in a timely manner, it will be subject to penalties of $100,000 per day until compliance is achieved. In addition, failure to meet acceptable levels of accuracy in making disability claim determinations will result in an additional penalty of $145 million. The reasons for these penalties are primarily because of Insurance Department findings that UNUMProvident failed to consider Social Security Disability awards as evidence of disability, failed to make sure that claims were reviewed by competent and impartial doctors, failed to have competent vocational assessments completed by competent vocational practitioners, failed to account for the assertions of claimants and their treating doctors, and failed to properly consider medical documentation establishing disability.

For a free consultation, call (888) 569-6013.

What Sets Us Apart?

  • Free Case Consultations Provided
  • 160+ Years' Collective Experience
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Client Testimonials

  • Your compassion for me and my situation is very much appreciated.

    “My thanks to you for pursuing my case with vigor. I don't know much about how these legal things are handled, but I could tell by your communications with me, making sure I was always informed, that you were on top of it all. Also, you were ALWAYS available to me to answer questions, and your compassion for me and my situation is very much appreciated. I have had limited exposure to the legal system and attorneys, but I have never been able to just call and talk to them, as I could with you. I always had to speak with someone in the office that couldn't really answer my questions.”

    D.B.

  • The light at the end of the tunnel was masked, but we found it!

    “I'm sending my heartfelt wishes to you and your team for a wonderful holiday. We celebrate Christmas this year with a lighter heart than past years - knowing how you made a difference for us and for so many others. The light at the end of the tunnel was masked, but we found it! And so, cheers to you and your incredible team. Have a wonderful and safe new year.”

    J.

  • Finding, and working with your team has been such a blessing to me.

    “Thanks again for all your help. Finding, and working with your team has been such a blessing to me. Deepest regards.”

    M.

  • First of all, I want to express my extreme gratitude for probably saving my daughter's life.

    “First of all, I want to express my extreme gratitude for probably saving my daughter's life. By staying in treatment, the improvement is remarkable. She had been in eating disorder facilities many times, and treatment had been interrupted repeatedly by Anthem Blue Cross's denying benefits. Many of the health professionals were telling me that maybe my daughter was a hopeless case. You both gave me hope. She is still struggling with some residual issues around eating, but the change in her attitude, her ability to assess her own recovery, and her wish to live instead of to die, is evident in her life. Now she is back in school, after years of having her education disrupted by the eating disorder. She goes places with friends, and even goes out to restaurants for fun! This year marked the first holiday season for many years, when she had not been in a treatment facility. Other people gave up and you didn't. I can't thank you enough. You took the action that was necessary to keep my daughter in treatment long enough for it to work.”

    Anonymous

  • We will never forget the good you have done and may you continue to earn gold stars.

    “More than your skilled expertise, uncompromising professionalism and breadth of experience, we have been immensely impressed with the sincerity, generosity and integrity with which you conducted our affairs, acted on our behalf and guided us through the sometimes confusing process. Throughout, we developed a great respect for all of you and it is our wish that both collectively and individually, you experience continued professional success and personal gratification in all that you pursue. We will never forget the good you have done and may you continue to earn gold stars.”

    Lalida C.