Unum Denies Long-Term Disability Claims – Texas
In the early 2000s, UnumProvident, a Fortune 500 provider of disability insurance plans, became the focus of accusations by lawyers and whistleblowing employees who claimed the insurer was deliberately and wrongfully denying valid long-term disability claims in Texas and other states.
Eventually, investigative news program 60 Minutes aired a report on Unum’s practices, and more than 40 states joined the effort to examine and correct Unum’s practice of unfairly denying claims.
The Department of Labor also looked into UnumProvident’s practices involving the Employee Retirement Income Security Act.
In 2004 Unum agreed to a regulatory settlement agreement with the group of state insurance regulators that addressed Unum’s record of rejecting claims.
The company agreed to significantly change the way the corporation was directed, to revise procedures for processing claims, and to fully re-examine decisions it made vis-a-vis disability insurance claims going back as far as 1997.
Claims Denied to Retain Reserves
Investigation into Unum’s history and practices revealed indications that starting in the 1990s the company began a policy of denying claims in response to the growing number of claims filed by customers who held “own occupation” policies. Such policies insured individuals with occupational specialties against disabilities arising from their particular occupational specialty.
The high demand for benefit payouts was compounded by the era’s low interest rates.
It is suspected that as a strategy to retain its financial reserves until a more fortuitous financial climate arrived, Unum began to deny long-term disability claims in many states including Texas by applying a set of stringent review initiatives that included heightened scrutiny of psychiatric claims; more frequent covert surveillance of claimants; insistence on having the claimant undergo dubious independent medical examinations; and:
- Changing policies without the authorization or knowledge of claimants
- Improperly investigating claims and relying on opinions from unqualified experts
- Refusing to acknowledge a disability
- Asserting the disability was a pre-existing condition
- Applying delaying tactics aimed at exhausting the claimant and ensuring a lower settlement
- Paying only partial benefits for a total disability
Claimants whose claims were denied and who received no or only partial benefits have the right to pursue litigation against Unum. If you have been denied long-term disability benefits in Texas by UnumProvident or another insurance company, call (512) 454-4000 today and speak with an attorney at the Law Offices of Bemis, Roach & Reed. The consultation is free, and you will be advised by a lawyer experienced in disability law who can help you recover the benefits you deserve but were denied. Bemis, Roach & Reed offices are in Austin, serving clients throughout Texas, including San Antonio, Houston, Dallas, Fort Worth, El Paso, Galveston and Corpus Christi.
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