Sunday, August 8, 2010

More on UNUM

Source: Article Bliss
Date:   August 7, 2010
Author: William Turley (trial lawyer in San Diego)

California disability insurance attorney - Unum, Unumprovident, Provident
Life & Paul Revere's

Based on publicly available federal court records, Unum, Unumprovident,
Provident Life, and Paul Revere companies have been named in almost 5,000
civil actions concerning insurance from 2000 to the present. The conduct
of these Disability Insurance companies has been beyond outrageous. Time
and again they have unfairly denied Disability Insurance Claims.

The following are findings of fact and law in a recent Federal Court
Trial concerning Unum, Unumprovident, Provident Life, and Paul Revere

Early in the 1990's Defendant UnumProvident realized that the claims made
on the own occupation insurance policies that it sold were putting the
company at risk. As a consequence the company underwent a major
restructuring of its claim handling practices and philosophy.

Provident went from a company that had a claim payment philosophy to one
that had a claims "management" philosophy. The results were profound.

Among the tactics that Provident developed as part of its new claims
management approach was the targeting of what it labeled "subjective
claims." These were claims based on mental or nervous disorders or
claims such as fibromyalgia or chronic fatigue syndrome ("CFS").

These claims which could not be proven by hard medical evidence such
as an x-ray were thought to contain a large potential for resolution
based on the vulnerability of insureds to pressure tactics.

Another of the tactics that Provident implemented was its practice of
claim objectification. Through its practice of imposing objective
evidence requirements on its insureds, when its policies contained no
such standard, Provident sought to defeat their claims. This standard
was imposed even on claims, where the company knew there was no way
to obtain objective evidence.

A third tactic that Provident developed was its use of round table
reviews. These reviews which involved claim personnel, medical staff,
vocational staff, legal counsel, and management personnel focused on
high indemnity claims. While notes were occasionally made of what
direction the claim should take after a round table review, company
policy was to destroy all information regarding who participated in
the meetings, what was discussed, and the basis for any decision.

Defendants' also attempted to cloak the round tables with the attorney-
client privilege in order to further insulate the actual claims
decisions and basis therefore from review.

A fourth tactic that was developed was the Defendants' practice of
shifting the burden of claims investigation to the insured. It is
undisputed it is an insurer's duty to conduct a reasonable
investigation into all available relevant information prior to denying
a claim. It is undisputed that an insurer must conduct a reasonable
and fair evaluation of the evidence in a non-adversarial fashion.

It is undisputed that an insurer may not deny or terminate a claim
based on speculation. It is undisputed that an insurer may not use
biased or predictable experts. It is undisputed that insurers have a
duty to assist the insured with the claim. Despite the existence of
these undisputed obligations that exist in the handling of first
party claims, Defendants instructed their employees that it was the
insured's obligation to prove his claim.

Employees were instructed to limit their use of independent medical
examinations ("IMEs"). Id. They were told that IMEs were not to be
used unless absolutely necessary.

The foregoing are just some of the outrageous tactics used by Unum,
Unumprovident, Provident Life, and Paul Revere companies. If your
disability claim has been denied by Unum, Unumprovident, Provident
Life, and/or Paul Revere companies you should consult with a
disability claim lawyer.

(c) 2010 Article Bliss

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