Robert J. Boumis  |  July 23, 2014

Category: Consumer News

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UnumUnum is facing another wrongful disability insurance claim denial lawsuit, alleging the insurance company acted in bad faith, violating the law.

The Unum lawsuit was filed by Dr. Robert Warner, alleging that Warner was disabled and unable to continuing working as a medical doctor with an OBGYN specialty. The text of the Unum lawsuit is sparse on details, but does state that Warner had a disability insurance policy with Unum, but was denied disability insurance despite presenting the insurer with supporting medical documentation.

Unum is the leading (by market share) provider of disability insurance. Disability insurance is a type of insurance designed to provide for the policyholder in the event that the policyholder becomes permanently disabled. Typically, disability insurance provides a set percentage of the policyholder’s pre-disability income. However, it has been alleged by Warner’s disability insurance lawsuit — and hundreds of others — that Unum has used illegal means to deny rightful insurance claims.

Bad faith is a legal term that means a party in a contract is trying to get out of the terms of their contractual obligation by illegal means. In the case of disability insurance, this means that one of the parties, typically the insurance company, is trying to avoid paying out to the policyholder. Unum has allegedly employed a variety of tactics to deny rightful insurance claims. This including demanding excessive documentation, having their own in-house physicians override the policyholder’s physicians’ determinations of disability, and argue that a person is technically not disabled.

Unum has faced insurance claim denial lawsuits over allegations that they have acted in bad faith. Additionally, the television news magazine “60 Minutes” ran an investigation in 2001, which found a physician who claimed had been fired by Unum after refusing to overrule patients’ physicians. The investigations also found that Unum agents were given a “denial quota,” a set number of claims they were required to deny.

Additionally, the investigation also found a “Hungry Vulture Award” given to the employee who denied the most disability insurance claims. After the investigation — and a number of disability insurance lawsuits and government fines — Unum claimed to have done away with such practices. Yet Unum lawsuits filed by individuals like Dr. Warner continue to allege that Unum is still denying legitimate insurance claims.

The Unum Disability Insurance Lawsuit is Robert H. Warner, M.D., v. Unum Life Insurance Company of America, Case No. 2:14-cv-00723, in the U.S. District Court for the Western District of Pennsylvania.

In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.

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