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Have You Been A Victim Of UNUM or another LTD Carrier Denial?? How to Protect Yourself

August 28, 2008. By Jane Mundy RSS FeedRSS   Del.icio.usDel.icio.us   NewsvineSeed Newsvine   FacebookFacebook
Columbus, OH: In 1997 Linda (not her real name) was involved in a serious car accident which left her disabled. Unumprovident did their due diligence and decided Linda had a legitimate claim. But in 2002, they had a change of mind—no reason, no explanation.

"Unumprovident talked to my doctors, they did a lot of research before they started to pay my long term disability benefits one year after the accident," says Linda. "Then they just cut me off, right out of the blue. And I had been paying into this policy for more than 15 years without a claim."

Unum VictimThe giant insurance company didn't even send Linda a letter of explanation. Linda re-read her policy and couldn't find any reason to have her disability payments stopped. "I made my payments to them on time, I was never late on a premium panyment," she adds. "They had absolutely no reason—my circumstances hadn't changed and I am still disabled. I was living on a very limited budget and panicked—what was I going to do? I couldn't afford an attorney…

"I called Unum (formerly UnumProvident) but don't remember exactly what was said because I have problems with my memory since the accident. But I do remember them saying something like 'That is our policy, that's just the way it is.' Then I asked them to send me a registered letter to explain why my benefits were cancelled.

Meanwhile, I still continued to make payments on my premiums because the reason they cut me off was obviously a mistake and I would soon be compensated—I assumed they would figure it out and I would get a check with back pay. I've been afraid all these years to stop payments to Unum. I thought about canceling my policy but then I heard about a class action lawsuit.

I heard that Unumprovident had illegally stopped paying long term disability benefits for no apparent reason on people like me who were disabled. Since Unum cut me off, I have been getting social security benefits and it has been a hardship. And I still haven't got the letter from them."

This is just one of the tactics UnumProvident (also called First Unum and Unum) uses to deny legitimate disability insurance claims. In cases like Linda's, they simply stop payments to policy holders without an explanation while others are denied a claim outright. Unum has found many ways to practice bad faith.

UnumProvident was accused of bad faith denials of legitimate disability insurance claims and a class action lawsuit was first filed in November 2002 but it was transferred to Tennessee and certified in September 2007. The suit alleges that UnumProvident devised a scheme to illegally deny or terminate the long-term disability claims of thousands of people in violation of the federal Employee Retirement Income Security Act of 1974.

The lawsuit alleged that UnumProvident, now called Unum Group, cut costs by denying and terminating claims; provided financial incentives to in-house physicians who would rubber-stamp previously made business decisions; and authorized more senior in-house doctors to change the written reports of other "uncooperative" in-house doctors in order to justify a claim denial or termination.

According to court documents, the class is defined as "all plan participants and beneficiaries insured under ERISA-governed long-term disability insurance policies/plans issued by UnumProvident and the insuring subsidiaries of UnumProvident throughout the United States who have had a long-term disability claim denied, terminated, or suspended on or after June 30, 1999, by UnumProvident or one or more of its insuring subsidiaries after being subjected to any of the practices alleged in the complaint."

An Unum representative said in September that "most, if not all, of the potential class members have already been well served by the claim reassessment process that is currently scheduled to conclude before the end of the year."

Linda has not yet been "well served" by Unum.



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Social Security Disability Hearing Delays in Tampa Bay and Propsed Legislation to Speed Up Your Hearing

A Times Editorial

Cut short disability's cruel waiting game


In print: Friday, July 18, 2008


 
 
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The government insurance that is owed to people who are no longer capable of working is no less urgent than that paid to a family left homeless after a flood. But the Social Security Administration has turned disability insurance into a waiting game so cruel as to sometimes claim lives before paying claims.

The bill that U.S. Rep. Kathy Castor, D-Tampa, is introducing in Congress would finally put the government on a clock. It would have no more than 75 days to schedule a disability claims hearing and, then, no more than 15 days to rule.

As Castor demonstrated with some of the people she gathered for a news conference on Monday, the delays and rejections are often indefensible. Shelly Burke, who suffers from diabetic neuropathy, has been unable to work since 2000. She was twice the denied the benefits she deserved, and won them only with the help of an attorney and only after eight years of delays.

"I don't know what I would have done without my mother," Burke said. "I've been one of the lucky ones.'

In fairness to the Social Security agency, its staff has suffered cutbacks at the same time it has seen a dramatic increase in caseload. It also faces far too many attempts to defraud the government, including recently disclosed attempts by private insurers to force their injured claimants to file, wrongfully, for Social Security disability insurance.

That said, the agency still suffers some of the institutional distrust that once led the Regional Appeals Office to report that bosses were telling caseworkers to "deny, deny, deny." The agency has rebounded from those ugly purges during the Reagan administration, but one reason for the staggering backlog of cases today is that far too many claims are being wrongly denied by the original caseworker. In turn, those denials are appealed, and two-thirds of them are reversed.

The assumption that everyone is trying to cheat the system has cost those who aren't. The average wait for a person filing a disability claim to get a hearing before an administrative judge in Tampa is now 685 days, and some cases last for years. Even Social Security Commissioner Michael J. Astrue has acknowledged that some disabled people have died while waiting. Yet Astrue has still done little to address the problem. Imagine the Federal Emergency Management Agency trying to prevent flood insurance payments for nearly two years after a storm.

More administrative judges and caseworkers will cost money that Congress has to be willing to provide, but Castor is shining the light in the right place. These delays are inhumane.

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Employer can reduce injured worker's pay

Question: I have a clerical job at a large, non-union health-care facility, in which one of my responsibilities is lifting and moving heavy file folders. A few weeks ago, I hurt my wrist on the job. It was painful enough that I had to go home, though not before I was required to take a drug-and-alcohol test.

For more information, follow the link below.

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Disability Cases Last Longer as Backlog Rises

RALEIGH, N.C. — Steadily lengthening delays in the resolution of Social Security disability claims have left hundreds of thousands of people in a kind of purgatory, now waiting as long as three years for a decision.

For more information, follow the link below.

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Study Shows Minimum Wage Not Enough to Live In Parts of Florida

People earning the state minimum wage of $6.79 an hour cannot afford to live in Nassau County, according to a recent study looking at what it costs to live here.

And even when the national minimum wage goes to $7.25 in 2009, it still won't be enough.

It takes a full-time hourly wage of at least $8.53 for an individual living alone to $24.65 an hour for a single parent supporting three babies to pay the most basic bills, according to the Self-Sufficiency Standard for Florida report issued in November by the Human Services Coalition, a nonprofit Miami organization that monitors health and human service needs.

For mor information, follow the link below.

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Starwatch consumer: Burger King pressures suppliers

Burger King is telling suppliers it may stop buying tomatoes from southwestern Florida, where farmworkers have fought to get the hamburger chain to pay more for its produce, according to a letter obtained by The Associated Press.

The Coalition of Immokalee Workers has tried for more than a year to get Burger King Corp. to join deals signed by rivals McDonald’s Corp. and Taco Bell owner Yum Brands Inc.

For more information, follow the link below.

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Employers owed $42 Million

Florida employers have saved millions of dollars on workers compensation costs since 2003 changes curbed premium costs.

Some of them are about to save even more.

For more information, follow the link below.

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Florida Workers' Compensation Rates Reduced For 5th Consecutive Year

January 28, 2008 -- On New Year's Eve, the Florida Office of Insurance Regulation released its annual report on the state of the market for workers' compensation insurance to the Florida Legislature.

The report detailed the availability and affordability of coverage for workers' compensation insurance in Florida for calendar year 2006. In conclusion, they found that Florida is the largest market dominated by private market insurers (as compared to state sponsored residual market entities such as those in New York and California).

For more information, follow the link below.

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Couple indicted in disability scam

A Rapid City couple was indicted last week in federal court for allegedly lying to the government to receive disability benefits.

Lonnie Holloman has received $123,333 in fraudulent Social Security Disability Income since sustaining a back injury in 1991, according to the indictment.

Prosecutors say Holloman worked full-time as a truck driver for Doug Faul Trucking Company between 1998 and 2001, after which he worked for his wife’s Holloman Trucking Company.

For more information, follow the link below.

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Insurance regulators release annual report on workers comp insurance, approve 18.4 percent rate reduction

Florida is the largest workers' compensation insurance market in the nation dominated by private market insurers, according to a state report released this morning.

The annual report to the Florida Legislature on the state of the market for workers' compensation insurance was conducted by the Florida Office of Insurance Regulation. It analyzed the availability and affordability of coverage for workers' compensation insurance in Florida for the calendar year 2006.

For more information, follow the link below.

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Keller Rohrback L.L.P. Announces Ongoing ERISA Investigation of the First American Corp. 401(K) Savings Plan

SEATTLE, Dec. 11 /PRNewswire/ -- Keller Rohrback L.L.P. (http://www.erisafraud.com) today announced its ongoing investigation against First American Corp. ("First American" or the "Company") for potential violations of the Employee Retirement Income Security Act of 1974 ("ERISA"). The investigation focuses on investments in First American stock by the First American Corporation 401(K) Savings Plan (the "Plan").

Keller Rohrback's investigation involves concerns that First American and other administrators of the Plan may have breached their ERISA-mandated fiduciary duties of loyalty and prudence to participants and beneficiaries of the Plan. A breach may have occurred if the fiduciaries failed to manage the assets of the Plan prudently and loyally by investing the assets in Company stock when it was no longer a prudent investment for participants' retirement savings.

For more information, follow the link below.

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Social Security disability cases are taking longer

RALEIGH, N.C. – Steadily lengthening delays in the resolution of Social Security disability claims have left hundreds of thousands of people in a kind of purgatory, waiting as long as three years for a decision.

Two-thirds of those who appeal a first rejection eventually win their cases.

For more information, follow the link below.

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Washington Mutual faces class action suit on alleged ERISA violations

LONDON, Dec. 7, 2007 (Thomson Financial delivered by Newstex) -- Washington Mutual (NYSE:WM) Inc employees participating in the company's 401(k) plan filed a class-action lawsuit, claiming the group failed to adequately monitor the plan and advise participants when the company stock investment was no longer prudent.

As a result, employee participants suffered total financial losses of more than 150 mln usd.

For more information, follow the link below.

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One Family Tries To Save A Home

SUNRISE (CBS4) ? People facing foreclosure come from a cross section of the South Florida community. Some were speculators buying condos and homes hoping to get rich, others bought bigger homes than they could afford.

The people hardest hit however are those who experienced a personal setback or tragedy shaking their very foundations.

Just two years ago, Jennifer Chapman thrived as a cheerleading coach in Weston. "My whole life has changed for the worse right now."

Jennifer cannot walk. An ATV accident left her in a wheelchair with nerve damage. Her doctors say she has Lou Gehrig's disease.

For more information, follow the link below.

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Immokalee farmworker rights group ready to protest today outside Burger King HQ

The Coalition of Immokalee Workers is ready for its massive boycott march toward Burger King corporate headquarters to get the fast-food chain to agree with their demands to improve wages and working conditions to farmworkers who harvest tomatoes.

After a statewide tour with peaceful protests and workshops, the organization’s national push will culminate Friday at the Burger King corporate headquarters in Miami.

For more information, follow the link below.

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Study Targets Prescription Savings in Workers' Comp for Chronically Injured

Chronically injured workers – those who remain injured for four years or more – represent only 17 percent of all injured workers, but account for 45 percent of all workers' compensation prescriptions, and nearly 65 percent of all pharmacy costs.

This means that the pharmacy needs of the chronically injured worker represent 65 percent of the savings opportunity, according to PMSI, a Florida-based provider of pharmacy and specialty products for workers' compensation.

For more information, follow the link below.

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Florida State Blocks Access To Billions In An Investment Pool; Small Governments Start Panicking

Tallahassee, Fl. (AHN) - Top Florida officials decided to freeze a state investment pool of $14 billion on Thursday, after the financial panic-driven school boards and local governments started withdrawing billions of dollars from the fund.

However, now some school districts and investors are worried and stuck as they cannot access their money.

For more information, follow the link below.

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Florida's minimum wage to go up to $6.79 January 1

The minimum wage in Florida will increase from $6.67 per hour to $6.79 per hour on January 1, 2008. The minimum wage applies to all employees in the state who are covered by the federal minimum wage. The definitions of “employer,” “employee,” and “wage” are the same as established under the federal Fair Labor Standards Act (FLSA).

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Florida Celebrates Disability Mentoring Day

Two high-school students with disabilities were creating a short digital film on Wednesday with help from Challenger Learning Center program director Harry Hawbecker. Their faces serious and their eyes focused on the computer screen in front of them, they finally cracked smiles when they got to take a look at the short film they had created on planets and stars in outer space.

Jason Allen, 17, and Josh Baldwin, 14, were among more than 70 young people and job seekers with disabilities shadowing professionals as part of Florida Disability Mentoring Day. The young people were matched with business leaders, city officials and professors from places such as Volunteer Florida, the city of Tallahassee, the Florida A&M University School of Architecture and the Florida State University French Department.


For more information, follow the link below.

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Regulators: Cut workers' comp rate even more

It's not just property-insurance companies that have earned special attention from state insurance regulators.

The Florida Office of Insurance Regulation also is pushing the "reject" button for other types of insurers operating in the state.

Regulators said Tuesday that Insurance Commissioner Kevin McCarty is calling for deeper rate cuts in workers' compensation insurance rates after rejecting a rate filing from the National Council on Compensation Insurance that would have saved Florida's employers more than $700 million.

For more information, follow the link below.

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Six Florida Contractors Cited In Surprise Sweep

TALLAHASSEE, FL (CompNewsNetwork) - —Investigators from the Department of Financial Services, Bureau of Workers’ Compensation Compliance, issued six Stop Work Orders (SWOs) during a surprise enforcement sweep last week of 39 contractor sites throughout Collier County. The SWOs were issued to contractors determined not to have workers’ compensation coverage for their employees.

Dubbed Operation Check Point, the sweep also involved inspectors and investigators from Collier County Licensing, who issued 11 citations, and the Department of Business and Professional Regulation, who issued three citations and two Cease and Desist Orders, all for unlicensed activity.

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National council recommends 16.5 percent rate decrease for workers compensation in Florida

Efforts to reduce workers' compensation insurance by 16.5 percent could save Florida employers $650 million.

So says the Florida Office of Insurance Regulation.

And that could help construction firms hang on to more workers during slow times, while off-setting other expenses for white-collar firms.

For more information, follow the link below.

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