First, some background. Torres, obviously, is a Native American. As a Sioux Indian, he is a member of a people whose land and culture, so rich with ancient wisdom and vibrant traditions, has been trampled over by generations of new Americans.

Torres also served in the United States Army from 1961 to 1964. After an honorable discharge, he served in the South Dakota Army National Guard for 19 years. He was just one year shy of retiring when he fell from a porch and severely injured his leg.

Torres has been earning a good living as an electrician, but instead of working, he had to undergo arthroscopic surgery at a Veteran’s hospital in South Dakota. Unfortunately, the surgery did nothing for him. The task of climbing a ladder, something electricians do unthinkingly throughout their work days, was now impossible for Torres. He went back for a second operation at the same hospital, but instead of helping him, Torres said that it crippled him for life.

Thanks to his leg injury, Torres was booted out of the National Guard because he couldn’t complete the physical training (PT) requirements. He hoped that because he was so close to retirement, the National Guard would waive the PT requirements for him. If he made it through just one more year, he could retire with a pension. But it was not to be. An officer told Torres that he would be “bounced” out of the Guard whether or not he signed the discharge papers. Even worse, a doctor at the VA hospital told Torres to “get a desk job somewhere.”

Handicapped and with nothing but a GED, Torres turned to the VA for a disability pension but was rejected. He applied again a year later and was rejected again. Then he took all of his medical records to the Social Security Administration, where he was approved for 100 percent disability. Puzzled, Torres can’t help but wonder, “How could the VA deny my claim and yet the Social Security approve them?”

Torres’ experience would seem like a textbook case of red tape and government bureaucracy, except for some evidence that indicates racial discrimination played a part. Melvin Brewer, a friend of Torres who ran a VA office on the Pine Ridge Reservation where Torres was born and raised, told Torres that it wasn’t unusual for the South Dakota Veteran’s Office in Sioux Falls, SD, to deny claims that he sent to them from the reservation. Out of six claims Brewer submitted by Native American veterans, six were denied. Giago’s column quotes Brewer describing his follow-up. “I called the office and asked about how many claims filed by Native Americans were denied, The irate secretary told me that no such thing would ever occur at her office.”

Brewer then resubmitted the same six claims, unaltered, and four of them were immediately approved.

Torres’ experience is an outrage. Why didn’t the government that Torres served faithfully for years treat him with the honor and respect that he deserved? What kind of message does this send to the younger Americans who are considering joining the armed forces? What does it to our national image when we treat some of our most valuable citizens so disgracefully?

SOURCE: Unum Denied Disability Claims › Native Americans face discrimination applying for disability

“Some companies have discovered that they can make more money by simply paying out less,” the AAJ report states. Unum routinely challenges legitimate disability claims, hoping that frustrated claimants will give up or settle for less than their claim is worth. The insurance company is also accused of devising a cost-cutting scheme in which claimants are directed to file for Social Security disability insurance benefits first, even though the claimants may be completely unqualified for such benefits. Claimants who failed to follow the procedure had their benefits cut by Unum, and the process added unnecessary stress to the already overburdened Social Security system.

Other Unum claimants, such as Debra Potter, who actually sold Unum disability policies for years, had their legitimate claims flatly denied for inappropriate reasons. When Potter was diagnosed with multiple sclerosis and filed a disability claim, Unum denied the claim, saying that her condition was “self reported.” Her doctor wrote several memos to Unum’s claim department telling them that “there is no basis to support that her complaints are anything other than legitimate.” Her employer, BB&T appealed to Unum on Potter’s behalf. Even the Social Security Administration concluded Potter was totally disabled. And social security disability is notoriously more difficult to claim than insurance from private providers. But Unum denied her.

After three years, Potter finally hired an attorney and Unum agreed to pay her disability claim.

Unfortunately, Potter’s experience is not an isolated incident. It’s a matter of practice. “The 10 worst insurance companies that made the list did so because of their shameful treatment of policyholders,” said Gibson Vance, president of the Alabama Association for Justice, in a response to AAJ’s report.

SOURCE: Unum Denied Disability Claims › Unum second on list of the worst American insurance companies

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