From 1996 to 1999 Unum Life Insurance ran a tight claims operation that included actively engaging in claims practices it knew were out-of-contract, unfair and potentially illegal. Still, the company played the numbers until it got caught in late 2002 when 60 Minutes and NBC Dateline aired exposes eventually leading to the Regulatory Settlement Agreement in 2004. Prior to 1999 the Provident Companies had already merged with Paul Revere and Harold Chandler and his henchmen including Ralph Mohney and Tim Arnold turned their sights to Unum Life Insurance as a viable take-over opportunity since the company had not been doing well since at least 1996. Under the former leadership of Jim Orr III and the failure of the 1998 People Goals to bolster profit targets, Unum Life Option trading loss recovery strategies was indeed an easy target.

Most of the vice presidential parachutes were heavily vested in stock options and Unum’s pension plan was also generously funded with Unum stock. In 1996 news of the pending merger appeared to have leaked out when sales management personnel attempted to engage in cash stock option exchanges resulting from inside information. As the compensation specialist who actually transacted these cash-ins on behalf of the executives with Smith-Barney it quickly became obvious information about the future of Unum Life Insurance as inside information was prompting a large volume of requests to sell or cash-in on Unum stock options. SEC rules at the time dictated a waiting period of 6 months before entering into any stock transaction resulting from inside information. People like Martha Stewart actually go to jail for that. Eventually, Unum’s Vice Presidents were forced to leave the company taking with them parachutes which now were grossly undervalued due to the stock split, insider trading, and financial upsets due to the 1999 merger with Provident.

Eventually, the VPs and other management entered into a class action lawsuit against Unum regarding the devaluation and misrepresentation of stock value afforded to them. Unum Life Insurance quickly with announcements that all claims decisions would be made  without the consideration of any information from the claimant’s physicians. From 1999 forward claimant’s physicians were left out of the claims review process. Therefore, after the 1999 merger UNUMProvident was able to create a fairytale of profitability by under reserving its financial reserves. In other words, ERDs were set by medical personnel and were approved by claim management who could then plan which claims were intended to be denied and in which month. ERDs were actually input into the BAS payment system. Instead of Unum recognizing the full financial reserve liability of the claim to age 65, the payment system only recorded a financial reserve to the ERD date.

Investors who determine bond ratings as well as federal and state regulators were fooled into thinking UNUMProvident was much more solvent than it really was. It is also suspected the system was changed in 2002 when the company was exposed on 60 Minutes and management may have feared further exposure. Claims specialists were held accountable to deny claims on or before the set ERD dates and the entire process remained an endless race to collect documentary evidence so that claims could be denied as of the date set by the ERD. Potentially, ERDs can be set to any arbitrary date coinciding with monthly, quarterly or year-end profit reporting. There is evidence in Unum claim files that ERDs are still being used  today as a management device in the claims system. While it is doubtful Unum’s management continues to integrate ERDs with its financial reserves, its ability to target the denial of claims in contradiction of the insured’s actual medical condition or ability to return to work is obvious. Unum’s use of ERDs also led to the use of MDA, a software medical recovery management program which sets arbitrary dates of expected recovery based on thousands of impairments and diagnoses.

LTD plans from a company which has no intention of providing a disability benefit to its employees. Unfortunately, Unum’s setting of ERDs is only one in a long list of internal strategies used to target and deny claims that should be paid. Insureds who are NOT clients of DCS should begin to ask their claim specialist what their ERD date is. If it’s earlier than age 65 you will get a good idea of when Unum plans to deny or terminate the claim.

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