Chattanooga, TNUnum Group CEO Tom Watjen knew he had his work cut out for him in 2003, when he took over a company that came with a fair amount of baggage. Over the years, the enterprise known as Unum Provident had lost marks for being arrogant, given to undisciplined pricing, and a not-so-great reputation for delivering on benefits.
Part of the fix involved a re-branding of the company to simply Unum, which was initiated in late 2006 and rolled out this year with the mantra, "Better Benefits at Work."
People who have been stung by Unum/Unum Provident over the years, will be watching the company, and their allegiance to the new slogan, with keen interest.
The U.S. Department of Labour (DOL) initiated an examination of the claims history of Unum/Provident (now Unum Group), and specifically three companies within the Unum umbrella: Unum Life Insurance Company of America, The Paul Revere Life Insurance Company, and Provident Life and Accident Insurance Company.
At issue were employee benefit plans covered by the Employee Retirement Income Security Act (ERISA). The resulting settlement agreement will see the three companies, as well as First Unum Life Insurance Company of New York, making changes to their claims practises, and a re-assessment of claims going back to 1997. A qualifying claim, either denied or closed outright by the company(s), would be eligible for a second look.
Unum Group has been on the firing line for a while, with a number of states launching individual investigations. In 2005, the Insurance Commissioner for the State of California made reference in the media to alleged irregularities carried out by Unum Provident, which today as Unum Group insures upwards of 25 million people worldwide.
Unum Group has been accused of misusing medical records, unnecessarily targeting high-cost claims for denial, attaching limitations to certain claims which would save the company from paying a claim, and the deliberate application of erroneous legal definitions when referring to disability, in order to avoid paying a claim.
There will always be the bad apples who try to take their insurer to the cleaners, and while it is always within the insurer's right to verify a claim, it's neither in the client's best interest, or in the interest of fair play to unnecessarily drag out the investigation of a claim, or simply troll for reasons to avoid paying.
Various states have launched separate investigations into the practices of Unum Group, including Maine, California, Texas and West Virginia. Upwards of 200,000 claims previously denied, or closed, are being re-evaluated.
Declarations by Unum Group reveal a payout of $4.2 billion dollars in disability benefits in 2004, with $25 billion parked in reserves for potential claims - so it's not like they don't have the money.
What they don't appear to have had, is compassion. The stories are legion:
A man in Manhattan was required to continue working even though he was prone to internal bleeding.
A widow was forced to wait for a year to collect a legitimate claim, a situation that pushed her into severe financial hardship.
A former manager with a brokerage firm in Studio City, California had a quadruple bypass at the age of 43, brought on partly by job related stress. His doctors told him he could no longer work, and is now considered disabled by both his employer, and the federal government, which pays him social security benefits. Unum Group, his long-term health insurer, refuses to pay on grounds that in their view - and that of their in-house medical expert - the man is not disabled. Unum Group has not examined the man, whose former employer still pays the premiums for the health insurance their disabled former employee cannot collect.
Unum says they'll look at it again.
More than 50 million American workers hold long-term disability insurance as a financial safety net. All fifty million pay their premiums faithfully as responsible citizens with an eye to the future.
They are little match for a huge juggernaut happily taking their money, with an eye to the bottom line.
If you have had a disability claim denied, or if your claim was granted and then later terminated, please contact a [UnumProvident] lawyer who will evaluate your claim at no charge.