UnumProvident federal trial in progress

October 2nd, 2008 by Kurt Niland

UnumProvident’s trial has begun in federal court in Boston. The insurance conglomerate has been accused of fraudulently sticking the federal government with several million dollars in . Some of the allegations made against the UnumProvident include an apparent cost-cutting scheme in which the company directed its claimants to file for Social Security insurance benefits first, knowing that they were completely unqualified for such benefits. Claimants who failed to follow this procedure by not filing a claim with Social Security first had their benefits cut.

Eligibility for Social Security is much more narrowly defined and harder to receive than eligibility for benefits from private insurers. In its attempt to unload so many of its claimants onto Social Security, UnumProvident likely added stress to the already overburdened system.

The scheme was brought to court on behalf of the federal government by a whistleblower. The hearing is “qui tam,” meaning the individual will be entitled to a part of any penalties imposed by the court against the company.

UnumProvident requested that a summary judgment dismiss the case, but the request was denied. Judge Patti B. Saris cited the company’s “fraudulent” conduct in her reason to deny the dismissal.

If UnumProvident is found liable, its penalty will include paying three times the government’s losses and $11,500 per faulty claim. Such penalties could spell disaster for the insurance giant, which has experienced financial and legal turbulence ever since its merger in 1999. The companies Unum and Provident merged thinking that a bigger size would entitle it to a bigger authority to raise prices. The monopoly mindset failed them, however, when customers resisted the hikes and signed up for policies with UnumProvident’s competition.

The trial will last approximately four weeks.

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This entry was posted on Thursday, October 2nd, 2008 at 4:51 pm and is filed under News. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

  • I find it very disturbing that people would try to take money from those who really need it. I am glad that these individuals are being tried - I just hope that the law does what is right and just.
  • It's incredible that these companies will take your money for years and years and then when you become disabled and need the money the most, they find a reason to deny your claim.
  • deborah phillips
    i was out of work for three weeks. i was ready to go back to work in two weeks. but at the end of the second week, i still was not able to walk or put pressure on my foot (hammer toe correction), i was in so much pain still. the doctors office extented my leave for one week. found at the end of that week that there were undesolved stitches embedded in my toe. unum denied my payment for that last week. hard as times are and my mortgage being due, these folks thought i was just going to allow this. they rejected my doctors note and went steadfast on my last doctors visit stating i was doing better. but not still being able to put my foot in a shoe and being in so much pain and then finding those stitches, was not know at that visit. i wrote them a letter where i was not playing with them. sometime letters just have to have common sense. i had my doctor himself (cheif of the foot and ankle department) write a letter. they reverse my claim and paid me. i blame the companies that we work for. they go for these companies that they know that have a history of deniening claims. everyone was suprise my claim was reverse, even the customer service rep. at unum. i do hope that they get what they get.
  • pegtuck8
    How did the trial turn out? I have just filed a claim with unom
  • Monopoly restrictive trade practices will not work-out always, corporate companies should stop dominating the Markets through their Mergers and Acquisitions.
  • Debboe
    Even though I worked for a company whom mangaed accounts for insurance claims, medical and other resources.
    When we were stating our Hippa protocols, no one believed that our medical information was prototected.

    These company's would order prescription history's. In less then minutes they would receive both the prescription history but also what that medication could be used for...

    So if a person medication history showed that a medication may be used for depression, bingo.
    How would most people know that a medicine, taken may or may be used for depression, would have there benefits terminated.

    So our doctors need to write down what that med is being used for...there is no shame to be depressed nor take medication, but for those who wasn't taking a med for depression that needs to in there records.

    It disscusses me. I am too disabled and this insurance company tried to change my medical evidence...my doctors new me, they stood up for me, but it didn't stop there, even though I had thousands of test results, no evidence of ever being diagnoses for depression, they provided the DDS office (I was unaware of any of this) with a tiny part of medical information, so guess what? I was declared mentally ill with no test results to confirm my medical claims.

    The local SSA Office called me, upset at what happened. They have provided the proof of other insurance company, but it is still hard to convince attorneys that fraud can happened (in midwest).

    I lost all my disabilty income and my husband lost his job. It continues to escalate and hopefully we will find the attorney form whom understands what is happening.
  • Hi Debbie,

    Thank you so much for your comment, and for sharing some of the frustration you feel about this situation. I know that there are probably a lot more people like you out there, who are disappointed and confused about why this kind of thing should be happening to them.

    If you would like Beasley Allen's attorneys to look at your situation and evaluate it, please let me know. You can email us directly at client.support@beasleyallen.com.

    Thank you again for sharing your experiences, and blessings to you and your family.

    Sincerely,
    Wendi Lewis
    Communications Director
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