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Originally Posted by Michael Haislip
UnumProvident for DI.
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http://www.bad-faith-insurance-claim..._lawsuits.html
Unum Provident Lawsuit
On November 5, 2002, a class action lawsuit was filed against Unum Provident in a Manhattan federal court. The class action Unum Provident lawsuit is just another legal action taken against the nation's largest disability insurer. The charges filed against the company state that Unum Provident has "illegally victimized, and continues to victimize, many thousands of disabled Americans". The class action lawsuit is seeking an unspecified monetary amount in addition to asking the courts to order Unum Provident re-evaluate every claim it has denied in recent years.
There have been nearly 3,000 Unum Provident lawsuits filed in the last five years. Former employees, as well as Insurers claiming the company denied claims in order to meet financial goals, pushing financial gain over legitimate claims, have sued Unum Provident. The class action lawsuit alleges Unum Provident created a paper trail to back the denied claims using the company's own medical staff.
Unum Provident maintains that they have never used questionable business tactics or bad faith, however, over a dozen former and present employees have come forward to verify the Unum disability claim denial tactics, including former vice presidents of Unum Provident. A former in-house physician at Unum Provident, Dr. McSharry, sued the company in July 2002 after being fired that previous January. McSharry says Unum Provident pressured him, as well as the other doctors, to go along with claim handlers' decisions to terminate claims.
Dr. McSharry says he was fired after he refused to sign off on claims. On the television news show 60 Minutes, Unum Provident bad faith business practices were disclosed by former Unum employees that have been confirmed by over a dozen current and former employees. The former employees disclosed information on Unum Provident saying the workers were told they must meet monthly targets that would come from the directors or above as to the sum of money that must be met by the end of the month in closures.
The bad faith tactics have been continuously denied by Unum Provident to date. The elected California Department of Insurance head, John Garamendi attributes Unum's risk of liability by continuing to deny or cancel claims to a matter of economic equation. Garamendi thinks that Unum Provident looks at how much business it risks losing versus how much business will be gained by denying the legitimate claims. So far, Unum Provident has been financially successful using bad faith business tactics and has avoided major liability.
The majority of lawsuits against Unum Provident thus far have been settled out of court and the company says most of the cases ending up in trial are won on their end. It appears Unum Provident may be running out of luck as bad publicity and a higher number of lawsuits are being filed against the insurance company. The recent class action filed against Unum Provident and the $7.5 million judgment upheld at the end of November 2002 by a San Francisco federal court found the insurance company used bad faith when closing a claim is more bad news for the insurance company. The court also found Unum Provident used employed biased medical examiners and improperly destroyed medical reports, in addition to other reports.
Even before 60 Minutes aired the Unum Provident news story, the insurance company issued a statement defending their claim handling process and stated they believed the show would be "incorrect in its implications". Some find Unum Provident's defensive forewarning to make them appear guilty. The largest disability insurance company by far, Unum Provident is now facing a critical time as they continue to be named the focus of bad faith lawsuits.
http://www.bad-faith-insurance-claim...al_policy.html
UNUM Provident Bad Faith Claims
Unum Provident Claim Denial Policy
Numerous former and current Unum Provident employees have come forward, continuing to confirm reports of bad faith insurance practices the company has been accused of using. Unum Provident provides disability insurance to 17 million Americans, making the insurance company the largest in the U.S. by far. Now Unum Provident bad faith claims are surfacing alleging their denial of legitimate claims, bringing negative publicity to the company.
Unum Provident continues to deny any wrongdoing in business practices used, however former employees from vice presidents to other departments confirm the same allegations that Unum Provident sets targets to close valid claims. Former employees say these financial targets were well known and widely used business practices that Unum Provident supported and encouraged by promoting employees that pushed the bad faith practices. According to a former claims handler in the Unum Provident headquarters, anywhere from $7-14 million was targeted to be shut down every month, varying depending on what departments needed help.
Roughly 3,000 lawsuits have been filed against Unum Provident in the last five years for closed claims or denied claims that policy holders feel were unrightfully denied. Some wonder how an insurance company facing such high number of lawsuits in addition to an increasing amount of bad publicity like Unum Provident can continue to use bad faith business practices.
The elected California Department of Insurance head, John Garamendi attributes Unum's risk of liability by continuing to deny or cancel claims to a matter of economic equation. Garamendi thinks that Unum Provident looks at how much business it risks losing versus how much business will be gained by denying the legitimate claims. So far, Unum Provident has been financially successful using bad faith business tactics and has avoided major liability.
According to Unum Provident financial reports in 1993, the insurance company was losing millions of dollars until new management totally turned the company around. Shortly after, Unum Provident reported gains of millions of dollars. The company attributed this financial turnaround to restructuring and sound business decisions, however some former employees attribute the financial success to different reasons.
An October 2002 Dateline investigation included a former Unum Provident employee, one of just two staff physicians employed at the time new management took over at the company in 1993. Taken in a deposition, former employee Dr. William Feist described how Unum Provident started holding meetings called "roundtables" where claims were cut from individuals costing the company, especially from those with subjective illnesses, such as mental illness, chronic pain, Parkinson's that had no ability to show up in actual x-rays or MRI's.
The Dateline investigation spoke with ten Unum Provident employees ranging from high offices of vice presidents to claim representatives that all reported on Unum Provident's denied claims. A 1995 Unum Provident memo outlined the company's goal of terminating $132 million in claims. A 2001 Unum Provident email shows a company wide goal of closing 18 or more claims in one week in order to meet projections made.
Still, Unum Provident continues to deny reports that the company sets targets for closing valid claims.
A good company for Disability?
