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UnumProvident settles multi-state federal examination of claim handling practices in USA, identifying Unum’s use of in-house medical staff to deny benefits.

What: The multistate market conduct examination (the means by which regulators examine the practices, policies, and behaviours of an insurer in the marketplace)  identifies several claims handling practices of concern to the state insurance regulators, including: excessive reliance on in-house medical staff to support the denial, termination, or reduction of benefits; unfair evaluation and interpretation of attending physician or independent medical examiner reports; failure to evaluate the totality of the claimant’s medical condition; and an inappropriate burden placed on claimants to justify eligibility for benefits. Maine Superintendent Iuppa said: “This action is one of the most significant multistate insurance regulatory actions in history.”

Why significant: Shows UnumProvident’s bad faith claims handling practices and the impact on disabled people were well publicised in the US at the time they were working to build influence in the UK.


'Multi-State, Federal Settlement Addresses Concerns Regarding Unum-Provident Claims Handling Unum-Provident Claims Handling',, 2004