UNUM: WON'T PAY INSURANCE'

by Jane Mundy

Susan Baker (not her real name to protect privacy) worked full-time for a Liz Clairborne outlet where she had an UnumProvident Insurance group policy which covered short and long term disability. In 2002, the bomb hit: she was diagnosed with breast cancer.

Susan was hospitalized, had one breast removed and underwent chemotherapy, and later, reconstructive surgery. She received short term disability (STD) from UnumProvident but her cancer was aggressive and the horrendous amount of drugs she needed caused severe muscle myalgia and back pain. And of course, the emotional trauma was overwhelming – Susan Baker was only 38 years old and single and she didn't have any family support.

Her STD expired in January 2003 and UnumProvident approved long term disability from January to March, 2003. One month! Her check came in the mail with a letter stating that she was not disabled. 'UnumProvident said their doctors had reviewed my file and they concluded that I was no longer eligible for benefits," said Susan.

"I talked to Michele, a claims representative at UnumProvident. 'Based on the evaluation of our medical doctors here, you are not disabled as of now,' she said. I never even saw their doctors. How could they evaluate me without even seeing me? I was so naïve and didn't realize I would never be denied benefits. My experience with her almost led me to a nervous breakdown. It was like she was telling me what I should be feeling, like she was my judge and jury.

"At this time I was really struggling with my deteriorating mental and physical health. From 2003 to 2005, I lived in five different places because I had no money to maintain myself independently. I had a tremendous mental response to my cancer and it was debilitating.

If it had not been through the grace of God and the care of others, I would have wound up on the street. I actually called the Salvation Army. It was frightening, especially because, right after chemo, your immune system is compromised and the last thing I should do is associate with people who might be unwell in a shelter situation.

Because Unum denied me long-term disability (LTD), I wasn't able to advocate and care after myself. Finally I got myself together and Social Security awarded me disability for the entire three years that Unum denied me.

During the time that I had no disability, no doctors, no medical care and no medication, for a cancer that was diagnosed as a stage three, Unum had a gamble going on. They knew there was a chance of a recurrence and a good chance that they wouldn't hear from me, ever. I believe they weighed the odds and figured I would need LTD for some time, so best to deny me right away.

So now, three years later, my cancer is back. Perhaps if I had the right treatment earlier on, when I was denied LTD, my cancer would have stayed in remission. If I had the follow-up drugs, they could have possibly prevented this recurrence.

I have to face a double mastectomy next week. I will undergo more chemotherapy, radiation and maintenance drugs. I am now 42 years old. It is pertinent to add that I think my statute of limitations has run out to seek any legal recourse in my state; I urge anyone who has been denied benefits by UnumProvident to seek an attorney immediately."

Susan Baker thinks the statute of limitations is up in her state but countless UnumProvident policyholders whose disability claims were denied have another chance to collect benefits. Some state Regulators have made a deal with the insurance giant – they are reassessing more than 300,000 claims denied since 1997.

UnumProvident must also pay a $15 million fine and change its claims practices immediately. As well, an additional $145 million fine will be slapped onto the insurance giant if a follow-up investigation finds it has not met the regulatory requirements.

UnumProvident has resorted to many underhanded tricks and tactics to deny claims. And countless people like Susan Baker have suffered due to their immense greed. In some cases the insurers totally deny a claim, while in others they pay far less than the policy holder is entitled to.

UnumProvident is one of the largest disability insurance underwriters in the U.S. that has been accused of bad faith denials of legitimate disability insurance claims. If you have been denied your claim by UnumProvident, we urge you to seek an attorney, sooner rather than later.

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Date of Disability:

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