UnumProvident: another Tactic to avoid Payouts

Unumprovident insurance company employs just about every trick in the book to avoid disability benefit payouts. Nancy King of Dewitt, Michigan got the run-around after she had an injury at work and applied for benefits that she was entitled to according to her policy.

"I worked for a general nutrition center (GNC) and I didn't think it would be necessary to file a claim at the time. When I fell that morning I was approached by the GNC maintenenace crew and they witnessed my accident. The property owners told me I was covered by Unumprovident so I didn't file a worker's compensation claim," she says. (Nancy was covered with the Unumprovident policy through work: her employers paid for it and she topped it up with $90 every two weeks.)

But for some reason the property owners later said that her claim would have to be taken up by their board of directors. Nancy then contacted an attorney and he told her that, because she had a work-related accident, Nancy was entitled to worker's compensation.

Because she didn't file right away, worker's compensation disputed the claim, even though she injured her neck, shoulder, elbow and knee. The accident occurred in February 2005 and she had neck surgery in May - a donor's bone had to be grafted into her neck.

Nancy contacted Unumprovident to cover short-term disability until her worker's comp dispute would be settled. She filled out the necessary paperwork and so did her neurosurgeon. She also provided them with information regarding the worker's compensation dispute. "I gave them everything they kept asking for," she says. Nancy's attorney made sure all the paperwork was in order.

And herein lies the catch: Unumprovident sent her a final letter saying she wasn't entitled to short-term disability because she was eligible for worker's compensation. "Their exact words were, 'If you are injured on a job you are not entitled to short-term disability,' but I can't file for long-term disability until I get worker's compensation," she says.

Nancy was told by Unumprovident that you can only draw short-term disability if a worker's compensation claim is denied. But a disputed claim can take over a year to settle and by that time it is too late for short-term disability. "Unumprovident is counting on the worker's comp settlement to take a long time so they will avoid paying short-term disability. I wasn't denied - it was in dispute. If I was denied it, I would have got short and long term disability," Nancy says.

Talk about Catch-22!

The insurance company determined later, when they got around to looking at the MRI results, that Nancy had a torn tendon in her shoulder. She was off work from May until the end of November - enough time to be eligible for long-term disability benefits.

Meanwhile, she lost her job and can't file for benefits until she gets worker's compensation which is supposed to be settled this October, 2006. "These are stories that need to be told so someone else doesn't find themselves in this position," Nancy says.