August 16, 2010. By Gordon Gibb
San Diego, CA: Unum is working to distance itself from its
unsavory past, but it's hard to escape the details that are emerging
from various lawsuits brought by disgruntled and distraught Unum
insurance policyholders who allege to have been wronged by the massive
Numerous Trials Reveal the Scope of Unum MisdeedsTrial lawyer
William Turley of San Diego, who sits on the Board of Governors of
Consumer Attorneys of California, notes that Unum, UnumProvident,
Provident Life, and Paul Revere companies have been named in nearly
5,000 civil actions concerning insurance from 2000 to the present.
In one recent trial in Federal Court, Unum Provident was found to
have addressed a concern in the early 1990s that claims against
occupational insurance policies threatened to put the company at risk.
It was found that the company moved from maintaining a claims payment
policy to one of claims management.
The firm adopted a variety of tactics to manage claims, including
discouraging the use of independent medical examinations in favor of
using its own medical staff, who might be persuaded to toe the company
Round table reviews involving medical staff, claims personnel,
vocational staff, legal counsel and management personnel focused on
high indemnity claims and how to manage them to the company's
advantage. Notes taken at the meetings were destroyed.
Turley notes that in some cases Unum put the burden on the insured
to prove that their claims were valid—even though it is an insurer's
responsibility to investigate the validity and accuracy of a claim in
a reasonable and fair manner without becoming adversarial and without
basing decisions on mere speculation.
According to facts uncovered from one trial, Unum targeted claims
based on emotional or nervous disorders, Fibromyalgia or Chronic
Fatigue Syndrome—conditions that are subjective and difficult to prove
with hard medical evidence.
The company viewed such conditions as affording high potential for
resolution in the company's favor, based on the vulnerability of the
claimants, and a hoped-for cancellation of a Unum long-term disability
insurance claim or similar claim against Unum.