Posts Tagged ‘Unum’s Breach of Contract’

Unum’s ERISA group plans contain SSDI provisions requiring claimants to apply for SSDI and “keep the process going” to avoid estimates and early offsets. Claims handlers quickly become annoying because of their constant chasing for SSDI status updates to ensure offsets are taken and benefits are reduced soon after approval letters are received from SSA.

Of late, however, Unum is estimating SSDI and reducing benefits despite information provided to it by claimants that the process of applying for SSDI is continuing. Threatening letters are sent to claimants that estimated offsets will be taken if information is not received. Even when SSA update letters are received Unum is estimating offset reductions from benefits, which by the way, reduce financial reserve and contribute to profitability.

Simply put, Unum’s Plans do not allow Unum to offset benefits with SSDI offsets, IF the claimant is continuing the process of appeal though the Administrative Law Judge hearing, or is re-applying for benefits.

I received several phone calls this week from claimants who have been harassed by Unum for SSDI updates already sent only to have their benefits reduced for estimated SSDI anyway. Unum is not abiding by the Plan document that writes claimants can avoid estimates if they follow through with SSDI appeals and the process in general.

Is Unum misplacing proof sent to it by everyone, or is it more likely that taking estimated offsets is a deliberate focus to bolster its profitability for year-end? In addition, the really awful thing is that when claimants are denied SSDI benefits Unum doesn’t give the money back alleging, “it’s obvious you would have been awarded anyway.”

My money is on Unum having a deliberate focus to estimate benefits for SSDI in clear violation of Plan provisions. In one instance, one of my clients (with my assistance) challenged Unum’s SSDI breach of contract and demanded the estimate taken be returned to her with interest. It was.

When challenged on this issue Unum doesn’t have a leg to stand on when Plan provisions are cited as back-up. Again, Unum cannot, via most Plan provisions, reduce benefits with an offset for SSDI unless the claimant refuses to apply, or doesn’t continue the process through with at least two levels of appeals – reconsideration and Administrative Law Judge.

Unum’s arrogance in blatantly and openly breaching its Plan contract is astounding. Claimants should always check their Plan or policy provisions for what it actually says about any issue raised by Unum.

It’s getting to the point where the company can’t tell the truth about anything.

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