DCS is receiving multiple calls and emails regarding Unum’s voluminous claim denials. Although most private insurers engage in “profiteering” tactics to some degree, I have not received any calls from insureds or claimants regarding sudden, unfair claim denials for 2016 from any other company.
Unum has been targeting and preparing claims for denial since the beginning of 3rd Qtr., and now within 3 weeks of year-end Unum has pulled out all of its bad faith practices to eliminate claims.
A good clue to Unum’s unfair “target-denial scheme” is the placement of Reservation of Rights status on claims just prior to profitability reporting periods. DCS is receiving more calls and inquires about ROR status and what it means to them.
In reality, ROR status is suspected of being connected to Unum’s BAS payment system. When coded, claim financial reserve is reduced thereby creating an immediate financial reserve gain and contribution to profitability.
Although Unum emphatically denies any connection between financial reserves and ROR status, the placement of increasing amounts of claims on ROR just prior to profitability reporting indicates the opposite. If ROR is NOT connected to BAS, then why bother with Reservation of Rights at all?
Unum’s counter arguments about ROR are simply not believable as indicated by increasing numbers of claims placed on ROR status at this time of year. More and more calls are coming in about Unum’s ROR status at a time when no other insurer is doing so.
It’s important to understand that deliberately targeting legitimate, payable claims for denial can be referred to as racketeering, particularly when it wouldn’t be hard to prove Unum’s “patterns of practice” to sell disability policies and Plans it has no intention of paying.
Further, Unum’s persistent violation of the multi-state settlement agreement along with state departments of insurance who turn blind eyes toward the company’s unfair violations of insurance law further disclose an extremely corrupt insurance industry against those who are most vulnerable in our society – the disabled.
We should also not forget that Unum deliberately harms thousands of middle class families who depend on disability Plans provided to them by their employers. For some, employer-provided group STD/LTD is the only affordable coverage for disability available.
Although I’ve mentioned this in many blog posts, it is so important to avoid denials in the first place rather than have to appeal and retain attorneys who walk away with most of the money. While consultants are not always successful, listening to the experts who know is also extremely important.
Clearly, given the numbers of calls and emails I’ve received, Unum is harming many people who won’t be having Christmas this year.