DATABASE FIELDS
1. *INSURED FIRST \\
2. *INSURED LAST \\
3. *INSURED ADD1 \\
4. *INSURED ADD2 \\
5. *INSURED CITY \\
6. *INSURED STATE \\
7. *INSURED ZIP \\
8. *INSURED PHONE \\
9. *INSURED E-MAIL \\
10. *INSURED FAX \\
11. *OCCUPATION \\
12. *ATTORNEY FIRST \\
13. *ATTORNEY LAST \\
14. *ATTORNEY ADD1 \\
15. *ATTORNEY ADD2 \\
16. *ATTORNEY CITY \\
17. *ATTORNEY STATE \\
18. *ATTORNEY ZIP \\
19. *ATTY PHONE \\
20. *ATTY E-MAIL \\
21. *ATTY FAX \\
22. *IS ATTORNEY 1 WILLING TO TAKE NEW CASES? \\
23. *ATTORNEY 2 FIRST \\
24. *ATTORNEY 2 LAST \\
25. *ATTORNEY 2 ADD1 \\
26. *ATTORNEY 2 ADD2 \\
27. *ATTORNEY 2 ADD3 \\
28. *ATTORNEY 2 CITY \\
29. *ATTORNEY 2 STATE \\
30. *ATTORNEY 2 ZIP \\
31. *ATTORNEY 2 PHONE \\
32. *ATTORNEY 2 E-MAIL \\
33. *ATTORNEY 2 FAX \\
34. *IS ATTORNEY 2 WILLING TO TAKE NEW CASES? \\
35. *LIST OF REPORTED DECISIONS \\
36. *AGE AT TIME OF DISABILITY \\
37. *DATE OF CLAIM \\
38. *NAME OF UNUM ATTYS \\
39. *FIRM NAME OF UNUM ATTY \\
40. *INVASION OF PRIVACY BY P/I? \\
41. *FRAUD BY PI? \\
42. *IME FRAUD ISSUE? \\
43. *MISREP ON DR. REPORT ISSUE? \\
44. *WAS UNUM ADJUDICATED TO HAVE VIOLATED ANY LAW? \\
45. *WAS THERE COLA RIDER? \\
46. *WHERE PMNTS EVER MADE? \\
47. *FIRST PMNT MADE \\
48. *LAST PMNT MADE \\
49. *EEOC RIGHT TO SUE LETTER SOUGHT? \\
50. *ERISA? \\
51. *DID FORMER EMPLOYER ASSIST IN CLAIM? \\
52. *DID FORMER EMPLOYER INTERFERE WITH CLAIM? \\
53. *STATE CLAIM? \\
54. *ON MORRIS \\
55. *ON 1,044? \\
56. *ON 2,152? \\
57. *ON UNUM TROUBLE LIST? \\
58. *HAS CLIENT FILED BNCY? \\
59. *SOLD THEIR HOME? \\
60. *ATTEMPTED SUICIDE? \\
61. *DIED PENDING LIT? \\
62. *CAUSE OF DEATH \\
63. *SOURCE OF FUNDS FOR LIVING EXPENSES? \\
64. *ORIG SETTLEMENT OFFER AS % OF POLICY \\
65. *FINAL SETTLMENT OFFER AS % OF POLICY \\
66. *PERCENTAGE DIFFERENCE ORIG TO FINAL \\
67. *COMPLAINT TO DPT OF INS? \\
68. *COMPLAINT TO AG? \\
69. *COMPLAINT \\
70. *STATE FILING DATE \\
71. *FEDERAL FILING DATE \\
72. *JURISDICTION \\
73. *VENUE \\
74. *DOCKET NUMBER \\
75. *CLAIM BY INSURER? \\
76. *SETTLED? \\
77. *WAS SETTLEMENT NET OR GROSS? \\
78. *DATE SETTLED \\
79. *CONFIDENTIAL \\
80. *DID UNUM FILE MSJ? \\
81. *DID INSURED FILE MSJ? \\
82. *RESULT OF MSJ? \\
83. *TRIAL TO VERDICT? \\
84. *RESULT OF TRIAL \\
85. *SSD DISABLED? \\
86. *MONTHLY BENEFIT \\ $
87. *DATE OF LAST UPDATE \\
88. *DIAGNOSIS \\
89. *BASIS FOR DENIAL \\
90. *UNUM \\
91. *Provident/Paul Revere \\
92. *Standard \\
93. *Cigna \\
94. *CNA \\
95. *Other \\
96. *BLANKET CONSENT FORM REQUESTED \\
97 *BLANKET CONSENT FORM SIGNED BY YOU \\
98 *CREDIT REPORTS DONE DURING CLAIMS PROCESSING? \\
99 *OTHER \\
100 *NARRATIVE \\
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The URL for this document is:
http://graham.main.nc.us/~bhammel/INS/LtdDBS2.html
Created: January 24, 2000
Last Updated: May 28, 2000