Unum Regulatory Settlement Agreement
In 2004, New York Attorney General Eliot Spitzer, New York State Inspector Gregory Serio, and senior supervisors in Maine, Massachusetts and Tennessee announced a comparison with UnumProvident and five of its subsidiaries. In 2005, Unum and all subsidiaries (including Colonial, First, Provident, Starmount and Paul Revere) entered into a transaction agreement with the California Ministry of Insurance (CDI) following an investigation into the subsidiaries` claims handling practices. As a result, Unum has agreed to change its practices and guidelines to comply with California laws. Unum also paid an $8 million fine and amended several policy provisions, including the definition of “comprehensive disability” in their disability policy. The comparison resolved problems related to Unum claims practices criticized by 60 Minutes and NBC Dateline. The investigations were conducted by the three main regulators as well as the U.S. Department of Labor. Attorney General Spitzer: “This comparison sends a strong message to disability insurance that inappropriate denial of disability claims is not tolerated.” The RSA is located between Cigna companies and insurance services in the states of California, Connecticut, Maine, Massachusetts and Pennsylvania, as well as other government insurance services that agree to participate in the agreement. The State of Minnesota has not yet agreed to participate. A national regulatory agreement between Unum Group, one of the largest passenger transport companies for persons with disabilities, and state regulators, signed in 2005, served as a reference for cigna`s audit and agreement. Cigna RSA contains corrective measures similar to those of Unum Group RSA. As part of the Cigna agreement, Cigna will re-evaluate previous claims that were rejected between January 1, 2009 and December 31, 2010, with the exception that the reassessment period applies to California residents from January 1, 2008 to December 31, 2010. The reassessment includes the audit of fees to determine whether the procedures agreed to under the RSA for expanded claims would affect the decision to refuse prior.
If the company finds that this would have an impact on the previous decision, it must pay additional benefits. With an aggressive and experienced disability, health and life insurance lawyer, the most important decision you can make for the success of your insurance rights.