Own Occupation Disability Insurance Policies
An “Own Occupation” definition of total disability means the inability to work at your regular occupation – that is to perform the material and substantial duties of your occupation. Under this definition, total disability means the inability to work at your occupation. The “Own Occupation” definition is favorable to you, the insured. The Own Occupation definition recognizes that a loss of regular occupation usually results in a drastic drop in income even if other employment can be found.
In the 1980's many disability insurance companies wrote “Own Occupation” policies because they were aggressively investing the premiums in the stock market. Which, of course, turned out to be a poor business decision. Many of these “Own Occupation” disability policies were sold to professionals: doctors, lawyers, and the like. The following saga is evidence presented and proven in recent Federal Court Decisions in involving Unumprovident, Unum, and Paul Revere.
Unumprovident, Unum, and Paul Revere – a Change in Claims Processes
Early in the 1990's Defendant UnumProvident realized that the claims made on the own occupation insurance policies that it sold were putting the company at risk. As a consequence the company underwent a major restructuring of its claim handling practices and philosophy. Provident morphed from a company that had a claim payment philosophy to one that had a claims “management” philosophy. The results were staggering. Unfortunately, the doctors and lawyers whom purchased these disability policies for the “peace of mind” received anything but, “peace of mind” when they suffered own occupation disabilities.
Provident was not the lone wolf insurer facing financial struggles due to poor product design, over marketing, and poor underwriting of its own occupation disability insurance policies. There were other disability insurance companies which faced similar problems. Many of these insurance companies left the disability insurance business. Paul Revere was one of the other large disability insurance companies that had also heavily hyped, marketed and sold “own occupation” individual disability products. Paul Revere also encountered huge financial issues with own occupation policies and, in response, changed it's claim processes.
Mergers and Agreements – The Plot Thickens
Thus, in April 1996 Provident and Paul Revere issued statements that they intended to merge. Provident and Paul Revere completed their merger in March 1997. Then, in 1999, Provident Companies, Inc. merged with Unum to form UnumProvident.
In 1998, Provident Companies, Inc. and Revere made a General Services Agreement. Under the General Services Agreement, Provident, and then UnumProvident, assumed all responsibility for handling Revere claims.
Before both the merger and General Services Agreement took effect, Provident was controlling Paul Revere's claim handling processes. Transition teams were formed. They drafted “Best Practices” which the combined entities were to follow and abide by. In 1996 Provident trained Revere's field investigators in these “Best Practices.”
Which included a claim objectification process Provident had initiated. Then the “round table” process of denying claims was started at Paul Revere even before the merger was completed.
The Unum Bad Faith Saga Continues
This is just one chapter in the continuing saga of Unumprovident, Unum, and Paul Revere. The evidence strongly establishes a corporate scheme to augment profits without regard to the rights of their disabled insureds – the doctors, lawyers and others whom had purchased Own Occupation disability insurance. Further, the evidence establishes Unumprovident, Unum, and Paul Revere. profited immensely from their misconduct. The results of these companies Bad Faith Disability Insurance practices has been devastating to many, many insureds. Instead of buying “peace of mind” – – untold number of doctors, lawyers, and professionals have faced economic ruin.
If you have had your Own Occupation disability claim denied by these companies, you are strongly advised to seek legal representation. A good Disability Claim Attorney can make all the difference to you and your families “peace of mind.”
