Disability Benefit Claims Law Blog : Disability Benefits Lawyer & Attorney : Dell & Schaefer : Disability Insurance Claims Law Blog

Verla Hancock participated in a group benefit plan sponsored by her employer, Intermountain Healthcare. The plan's claim fiduciary was Metropolitan Life Insurance Co. (MetLife). Under the plan, Verla obtained basic life insurance, supplemental life insurance and accidental death and dismemberment coverage (AD & D).

The plan stipulated that in order to benefit from the AD & D coverage, the policy holder had to be 1) Injured in an accident; 2) The accident had to be the sole cause of injury; 3) The accident had to be the sole cause of death; 4) The death had to occur within 365 days of the accident. The District Court found that policy beneficiary Terri Hancock had failed to demonstrate that she had a claim against MetLife for accidental death and dismemberment in her mother's death.

Would Terri Hancock's appeal be successful? Let's look at the facts surrounding Verla Hancock's death.

→ Click here to continue reading 10th Circuit Court of Appeals validates MetLife's accidental death and dismemberment denial

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Ronnie Hogan sued Provident Life & Accident Insurance Company (Provident) and Unum Group Corp. (Unum) asserting claims under Florida law that the insurance companies had failed to attempt in good faith to settle his claim. Hogan also accused the insurance companies of making misrepresentations that would have made a settlement less favorable for him. He accused them of exercising general business practices that involved mishandling claims, breaching their fiduciary duty, common law fraud, negligence and even conspiracy to commit statutory violations. Provident and Unum asked the judge to dismiss Hogan's case based on a failure to state his claim or at least to pass judgment based on the pleadings presented by the two sides.

→ Click here to continue reading Unum's claim handling exposes them to a multi-million dollar bad faith disability lawsuit

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In 1989, The US Supreme Court declared that if ERISA plans contain language giving plan fiduciaries discretion to interpret the terms of the plans and to make benefit determinations, courts will generally yield to that discretion. As a result of this discretion, insurance companies were able to deny claims and there was very little that courts could do to reverse the decision of an insurance company. Throughout the past several years, many states have passed laws to ban discretionary clauses and the insurance industry has been fighting to keep the discretionary clauses.

→ Click here to continue reading Insurance Industry Loses Lawsuit Challenging the Abolishment of Discretionary Clauses In ERISA Long-Term Disability Policies

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To hear company officials tell it Unum is emphatically on the mend, this after the disability insurer was wracked by scandal and losses earlier in the decade.

In 2005, Unum reached a costly settlement with attorneys general in 49 states over allegations of unfairly terminating or denying coverage to disabled clients. That was after a 60 Minutes exposé pilloried the company.

Its other big problem was in the profit department, the result of horribly underpricing policies sold to doctors, lawyers and other professionals. Those policies are now in "run-off" mode, with beefed-up reserves for claims, meaning they can die a slow but less costly death.

→ Click here to continue reading What Is The Financial Future Of Unum?

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Feb 3, 2009 - Unum Group said on Tuesday that net income fell sharply in the fourth quarter, hurt by investment losses, but operating earnings beat Wall Street expectations by a penny.

→ Click here to continue reading Unum Profit Falls in 4th Quarter Due to $167.6 Million in Investment Losses

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