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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 (818) 886-2525.

What Sets Us Apart?

  • Free Case Consultations Provided
  • 160+ Years' Collective Experience
  • Thousands Of Cases Successfully Handled
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Client Testimonials

  • 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

  • Thank you a zillion times for your patience and time and absolutely helpful information.

    “Thank you a zillion times for your patience and time and absolutely helpful information. You've helped me understand my position with my disability insurance and payments so much better. There is some real comfort in feeling anchored in knowledge…of what is and what might be in the future. Thanks to you!”

    B.

  • I've already mentioned your firm to my family and friends and how wonderful you have been treating me.

    “I've already mentioned your firm to my family and friends and how wonderful you have been treating me. Hopefully I will not ever have the need to refer someone to you because that would mean they would be in a similar situation as myself. But, if that were to ever happen, I would absolutely refer them to your company.”

    Linda P.

  • I won the appeal.

    “Hi Glenn- This is a very belated thank you for your generous assistance and advice last summer, when I was appealing UBH's decision for my son. I won the appeal, at least for care at the partial hospitalization level (they wouldn't budge on residential, but the facility was accepting the partial care reimbursement for residential treatment). But the appeal was a great moral victory, and I think it's a great thing to have in the record, just in case he needs to go for treatment again. Thanks again for your generous help, I was very grateful for it. Wishing you a most happy Thanksgiving.”

    Terry S.

  • The arguments you made on our behalf at the mediation resulted in a more positive outcome for our case than we could have otherwise expected.

    “We appreciate that you found merit in our case, and that you were both willing and able to be present at the mediation. We believe that the arguments you made in our favor to the mediator were able to influence the outcome towards resolution that we could feel satisfied with. In the end, we believe that your counsel, your support, and the arguments you made on our behalf at the mediation resulted in a more positive outcome for our case than we could have otherwise expected. Throughout you were always professional, but direct and clearly firm on our position. We thank you for your efforts to resolve our dispute to our satisfaction, and wish you continued success.”

    Mara T.