Unum Claims Handlers Take Issue with Prior Post

This week I received feedback from Unum claims handlers regarding my prior post using words such as “ass” and “fool” which, believe me,  are no strangers to my UNUM SPEAK vocabulary. However, I have often viewed claims handlers in general to be victimized as well as the insureds who receive endless denial letters in the mail.

While I have never openly criticized Unum claims specialists for doing what they need to do to protect their jobs, I  have never supported the old excuses such as, “We don’t do that”, or, “ I don’t do that”, or”Unum doesn’t just deny claims.” There does come a point, in my opinion, when any intelligent, rational human being, working as a Unum claims handler cannot and should not, ignore what’s right in front of their face on a daily basis.

Most Unum claims handlers are at least aware of the Multi-State Settlement Agreement, Georgia Conduct Market Evaluation, California Settlement Agreement in which Unum was required to pay millions of dollars in fines and reassess roughly 250,000 claims denied between 1999 and 2004. Although Unum employees celebrated the end of the reassessment with cake and cookies, the Unum reassessment was no party and cost the company millions.

Although Unum’s management brain washes employees into thinking the current claims process is different, it’s my guess very few Unum claims specialists have actually read the Multi-State Settlement Agreement to determine for themselves whether the current claims process really is different and more fair. (The Multi-State Settlement Agreement can be located on-line.)

Daily manager harassment with IMT sheets in hand sounds a great deal like “targeting claims” and “let’s deny the biggest bang for the buck” especially when directors put names on the sheet identified by them or Quality Complaince. Just because claims handlers do not have access to financial reserves doesn’t mean Directors, VPs and Quality Compliance do not have programs that access the information. 

Any claim deliberately put on a list, or IMT sheet has already been targeted as non-compensable by those who represent the business interests of Unum. And… Unum claims handlers know it. Targeting claims is an unfair claims practice even when directors and  managers sell it as perfectly legitimate.

Unum consistently denies having claim financial reserves, but it would be impossible for Directors and VPs to roll in the profits they do without having some indicator or financial benchmark guiding the LAR or “Liability Acceptance Rate”. During the “exposed” years Unum’s management told regulators it paid 98% of claims, which if I had been a stockholder at the time, I would have immediately sold my stock!

In reality, Unum Group deliberately targets and denies claims at the expense of insureds and claimants solely for the purpose of bolstering profitability. Unum’s management also designs internal protocols, strategies and procedures creating the illusion of credibility that claims denials are appropriate. Unum’s management conjures up all this at their “offsite meetings”.

Unum engaged in unfair and egregious claims practices for a very long time and after the reassessment process when regulators were no longer looking, Unum redefined their “horses of a different color” and continued doing the same things the company was fined for previously.

Any federal or state regulator willing to sit down and actually look at Unum claim files subsequent to the Multi-State will be able to identify many of the same unfair practices Unum agreed to stop.

This information isn’t coming from Linda Nee by the way. There is sufficient public information available from other sources such as federal and state regulators to support Unum’s history of bad faith claims practices. The public no longer demands whistle blowers; it’s all a matter of public record.

Unum’s reorganization from UnumProvident to Unum Group didn’t change the public’s perception of Unum either. Unfortunately, Unum never lived up to its new marketing tact of “a people organization” and basically didn’t “walk the talk.”

No insurance company anywhere actually ceases to engage in unfair practices when these same practices have been determined to have been profitable in the past. Unum, in particular, simply renamed its departments and titles and went about their business.

Do Unum claims specialists know about all this? In my opinion, Unum DBS’ would need to be pretty blind and ignorant not to. Unum protocols are directly in their face every day; Directors are pushing the IMT sheets, ERDs must be met, and life at Unum goes on targeting and denying as many claims as it can.  And……………..Unum claims specialists are complicit in that endeavor. 

Let me ask our Unum employee readers a few questions. When your Director demands you deny this claim, or that claim, or  tells you to AP&C a claim on the spot, what do you think that’s all about? Do you think it’s appropriate for your manager to query your unit peers when he/she wants to gather information about you?

When was the last time you were forced to present a claim at roundtable? Do you think it is appropriate for Quality Complaince to demand a Unum Medical Director change his report to favor Unum’s denial decisions? Do you think it’s appropriate  to sign your name to letters re-written for you by your Director or manager? Do you not think the insured has a right to know who really wrote the letter with your name on it?

Again, while I have never criticized any Unum claims handlers for doing what they needed to do to keep their jobs, I absolutely do not support, nor do I defend the myriad of endless defenses raised by Unum handlers which they know to be entirely false.

Unum Group deliberately targets claims to deny them unfairly for profit. That’s a historically supported fact and Unum claims handlers know it. It’s also truthful to say Unum claims handlers will eventually be victimized themselves by the company if they challenge internal protocols,  are female, over 40, or become seriously ill.

My recommendation to Unum claims handlers is to research Unum’s history, read about the company’s unfair claims practices, and decide for yourself if what you are currently doing is different and fair. 

You owe it to yourself, separate and apart from what Unum tells you, to judge your own sense of fairness and ethical standard to what you have been asked to do as a Unum claims handler.