Eligibility for Social Security disability 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.

SOURCE: Unum Denied Disability Claims › UnumProvident federal trial in progress