A collection of short insurance horror stories:
They're all doing it.



Date: Thu, 08 Oct 1998

STEVE PETEET IS DEAD.  Steve thought he had insurance through his
employer, to cover him in the event of his inability to work and to provide
income for his wife and 2 young boys.  What Steve's employer purchased was
not peace of mind and financial security for their employees but torture
and persecution.

For over a year and a half a group of us have been trying to get the
media to report this atrocity:
DISABLED POLICYHOLDERS LITERALLY PERSECUTED AND TERRORIZED by their
insurance companies after filing claims at the urging of their doctors and
employers.  On September 30, 1997, Steve saw one of my Internet warnings
about UNUM.  His response "I am on the verge of suicide, in spite of UNUM's
obvious delight at such an outcome."

I contacted him immediately and we averted a disaster.  Steve decided to
keep trying. But after another year of greedy do-nothing lawyers, betrayal
and bullshit from the Department of Insurance and the Attorney General,
and his own intractable back pain, Steve took his own life.

He thought maybe his life insurance policy would give his small family
some financial help and he knew he was out of the contestibility period
for suicide. UNUM Insurance Company refuses to pay the life insurance
benefits either.

The death of this man, a die-hard, conservative, God-fearing Republican
stockbroker who served in the Navy is on your conscience, James F. Orr III
(CEO of UNUM). Oh, I forgot, you don't have a conscience.

UNUM Insurance Company, James Orr and a host of co-conspirators now
stand accused, in the lawsuit I am filing in Federal Court, of Murder,
in addition to numerous counts of Racketeering, Fraud and Extortion.
They didn't want to pay Steve's benefits, so they drove him to suicide.
How many others are there that I don't know about???

Only corruption in the Courts (or a suspicious accident) will keep me
from exposing this now.

As I've said all along, UNUM Insurance Company and their accomplices
truly are:

Unethical
Nasty
Underhanded
Murderers

----------------------------
Date: Sat, 29 Aug 1998 15:34:24 -0400
Subject: How long can they claim this is all just anedotal or 

UNUM - Name withheld by me - "have recently been awarded LTD thru UNUM
after months of delays and asking for additional info...then only
awarded one year on "self-reported symptoms" even though the policy
calls for 5 years and physicians and documentation show  (lots of
abnormalities).  "They want a Label other than fibromyalgia even though
the unspecified connective tissue disease may not be definitely
diagnosed for years.  Recent documentation have proven that fibromyalgia
and CFS to be as debilitating as RA, but the LTD carriers are not
recognizing it.  So for now, I am able to catch up some bills (am sole
support for myself and son).  But I expect to have to deal wit the same
BS come March.  Keep up the good work."
----------------------------
UNUM - Name withheld by me - "my mother has been denied further benefits
from UNUM.  My mother is 56 years young, but she is still disabled
according to her doctors.  I feel she should be paid to the policy term
of 65 if her disability continues.  UNUM is trying to settle with her
for some small amount that only corresponds to six months of payments. 
Before this offer, they kept on giving her a run around and also kept
changing the claims people.  They even made her do some type of physical
performance test (that at first they would not pay for) at the urging of
her doctor.  Her disability was so bad that the therapist would not even
allow her to do one part of the test.
Even with the test over, they are not fairly negotiating with us."
-------------------------------

UNUM - "I was recently refinancing a house and ordered a copy of my
credit report from Equifax.  Guess what?
UNUM ordered a copy of my credit report last September about a month
after I filed my claim."
-------------------------------
*******************************
I'm going to start posting comments from people with other insurance
companies too, some of these stories are even more outrageous (if that's
possible) than UNUM's.  However, I have NO REASON to doubt their
veracity.

Standard Insurance - "I first filed in January, 1988.  I have had 4 MD's
and my employer put into writing that I can no longer do my job.  I have
full body RSD (reflex sympathetic dystrophy). I still have not gotten a
final denial, it is  with their "appeals dept.  I have 5 children and we
are struggling not to lose everything.  I am only 45 and never dreamed
this could happen to me from a silly accident.  I cannot do anything
legally till they five me a final denial.  The appeals dept. has had it
for 60 days, and I was just notified they were extending the decision
another 60 days.  After that it comes to my home state for a review, and
only after a denial from them (I have been told it would be rubber stamp
denied) can I attempt to get an attorney to intervene."

"The article in the paper today about you was something I really needed
to see today, to give me another reason to hang on, and try to keep
fighting.  Neither one of us, or all the others deserve this."

------------------------
Provident/Paul Revere -

Caryn Montague - IYAMHUIYAM@aol.com - "I have been a licensed life and
health insurance agent for 20 years in Florida.  When I went out on
claim almost 9 years ago, following a tough pregnancy and
life-threatening post-partum infection, I truly expected to be able to
count on my insurers.  After all, I had bought that which I had sold my
client; Peace of Mind.  Over the last week or so, since I became
acquainted with the net, I have experienced a severe case of deja-vu. 
To think that I got the same letters, calls and visits as others...."

"I am still out on claim, although on a much reduced, and recently
threatened basis.  It would be very therapeutic for me to help return to
the public the sense of security we should never have lost in the
insurance industry."

Caryn is the unofficial co-ordinator of the Provident/Paul Revere
claimants. Please contact her if you are one.

----------------------------------------------------------------------

This message is from Caryn Montague (IYAMHUIYAM@aol.com).  She is now
the unofficial coordinator of Paul Revere/Provident claimants because
she has taken some initiative to do so.  Caryn was an insurance
salesperson and an expert witness in insurance bad faith cases.  Despite
that when she became ill she was too weak to fight her wrongful denials
and recissions of her contracts.  Her life was a shambles.  Paul Revere
took full advantage of it.  Now she is fighting back.

Caryn is responding to the suggestion that we all, at the very least,
compile (to Jack Artale) a compiliation of our premium costs and the
policy provisions that the company changed AFTER the claim was filed.

In my case, I was paying about $150 per month on my individual policy
for about $5500 per month in benefits, own-occ.  (It was lower, both
premium and benefits but was raised every so often by UNUM).  I was
offered an opportunity to increase my benefits further around 1994 when
UNUM decided to stop selling these policies, but I declined because my
coverage seemed more than adequate.

I also coincidentally was covered under a group DI policy from my
hospital at the time I became disabled.  I don't know how much they were
paying for this but apparently I was also required to contribute part by
virtue of being and "Emergency Doctor."  I don't know how much I was
contributing (It wouldn't surprise me to find out it was more than
half).

In order to satisfy claim, both policies has language that simply stated
all I need do was supply "sufficient" proof of loss or proof of claim
from my attending physician (who could not be a relative).

UNUM apparently has a "different" definition of "sufficient," "proof,"
and "disability" than was in their policy but refuse to give me a
definition or any suggestion for how I could meet this, simply a blanket
statement that THEY don't feel I'm disabled from my primary occupation.

They also have a their own definition of "full and fair," honesty and
integrity, and many other terms as evidenced by my experiences.

Judydoc

> 
> Judy copied  me on the note you sent regarding the publishing of premiums.
> Having been in the industry when the rates came down and the benefits went up,
> I recall much of the rating proceedures.  Rates were always based on
> occupation, type of contract (policy) desired, age, sex (depending on company,
> form, and occupation), elimination period, benefits period, and options.  The
> professionals- dentists, physicians (MD, DO) , lawyers, etc- were offered the
> most lucrative policies with the most affordable premiums.  Insurance
> agents,executives, stock brokers, etc could qualify for the same contracts and
> benefits if the proposed insured met the stringent guidelines in income,
> length of time at position, credentials.
> 
> In my opinion, when the insurance companies started heavily marketing to the
> professionals, about 20 years ago, they did so with products that were not
> actuarily sound.  In other words,  there had not been sufficient "experience"
> with disability income replacement products to suddenly be taking the liberal
> positions that were taken.  When you factor in some of the illnesses around
> today, the "burn-out" claims, the occupations where people cannot be expected
> to perform at high capacity beyond their early years, as well as low return on
> the premium dollar, investment-wise, you are looking at a time-bomb.   Coupled
> with the advances in Modern Medicine, the industry could think they could turn
> a profit on this market.
> 
>   Additionally, the professional markets had the reputation of being comprised
> of people who tended to recover faster, speeding their way back to their work-
> We had been taught that it was the blue collar, and working class that
> malingered ....and their rates and contracts supported the "fact."  The
> society shifted in the last few decades from the "Father Knows Best" mentality
> to the Me First mentality.   I never believed in, nor recommended own occ
> clauses as I felt that if someone was trained at something he'd get back to
> it, or find something where he'd make income commensurate with that which he
> had prior to disablity.  (I sold Own Occ,  in policies and on riders.....but I
> was not a big fan of it....I thought it a disincentive- besides which, most
> definitions of disability provide for  "material and substantial duties...at
> time of claim.")
> 
> I support Judy's efforts because I feel the travesty here is huge.  The claims
> I have seen in the last few weeks appear to follow some patterns.  If, in
> fact, the  insurance industry has abused the trust we need to have in it
> something must be done.  I don't think the contracts were marketed
> fraudulently- I do think the companies got scared, really scared, when they
> started seeing claims coming in and dollars going out.  From a business
> prospective I can understand the value of weighing the legitimacy of each
> claim.  What I cannot understand is the  flagrant use of  policyholders monies
> at times when a claimant is ill, injured or otherwise deserving of payment of
> promised benefits.  The bouncing of a claimant from one "adjuster" to the
> next, the ordering of tests replicating those already on charts, the
> redundancy of  demands concerning financial information is abusive- it is also
> 'underwriting at time of claim'.....which I've now seen alot of, even on
> policies way beyond the contestability periods.
> 
> Wow, I didn't mean to "rant"- I generally leave that to Judy!  Jerry, your
> point is well taken.  Publish rates, give applicants the choice.....I  just
> don't see that as the problem.  I see a big problem  with the big few
> insurers, and I see a bigger problem with those of us who feel we've been
> wronged but cannot come together to get something done to remedy the problem.
> I truly thought mine was the only mishandled claim.  As one voice, I am weak.
> My voice, coupled with Judy's, gains in strength.  The people who have claims
> mishandled are the top echelon policyholders- we're the ones who can make the
> noise.  We earned the big bucks, had friends in high places, held important
> jobs and positions in our communities.  (I cannot even fathom the number of
> blue-collar and working class claimants who have been wronged and aren't savvy
> enough to network as we have.) We need to elect to make the noise...together
> we can be heard.
> 
> I hope you will be in touch as I am aware that you are pretty much in the same
> boat as me.   Judy has mentioned your name a couple times, but  I cannot
> recall if she told me about your situation-  she'd have just told me you're a
> member of "the fan club."   Wishing you well, I am
> 
> Caryn Montague


************************
This one I am quoting anonymously.  This person was 2 weeks from her
court date with lots of evidence against her insurance company. But her
own attorney was encouraging her to settle, and she and her family were
worn down financially and emotionally.  So no court case, no media
exposure against the insurance company.
She says "I settled yesterday.  I signed a confidentiality agreement
that I am comfortable with though I do have limits that I need to
honor.  I expect this will not come as good news to you...and I didn't
find it EASY by any means.  BUT, I am OUT FROM UNDER and it feels
wonderful.  I saw the handwriting on the wall and it would likely have
been 5 more years due to possible appeals if we won because the way we
would have to win would be blazing new ground in the law and that would
give an automatic APPEAL to the defendant and THAT was too long for me
given I have been at this already 11 years with theis company...I want
to move on...I am very satisfied with the settlement as is the company. 
This did not come easily."

[ My comment: I do not know any other details.  All I know is that this is just another very damaging case that the insurance company managed to avoid
court exposure, setting legal precidents, and publicity by BLACKMAIL and
EXTORTION.  These gag clauses are NOT legally binding but after years of
hell with these insurance companies and years of dealing with lawyers,
it's unlikely anyone who has signed one would be willing to come forward
and challenge it and risk the insurance company trying to get the money
back.  In other words, people are SCARED to talk.  Scared of going back
into litigation hell, scared of going bankrupt fighting to get to
court.]

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The URL for this document is:
http://graham.main.nc.us/~bhammel/INS/jmcoll.html
Created: August 30, 1998
Last Updated: May 28, 2000