View this article online: https://www.claimsjournal.com/news/southeast/2005/01/14/49679.htm
West Virginia Insurance Commissioner, Jane L. Cline, has signed separate multi-state settlement agreements with three major disability insurance carriers owned by UnumProvident Corporation of Chattanooga, Tenn. More than 40 states have joined West Virginia in ratifying the settlement agreements.
The agreements stemmed from a coordinated, nationwide, market conduct exam of UnumProvident Corp. and its subsidiary disability insurers. West Virginia, through the Office of the Insurance Commissioner, participated in the exam spearheaded by insurance regulators in Tennessee, Massachusetts and Maine. The affected companies doing business in West Virginia are Unum Life Insurance Company of America, The Paul Revere Life Insurance Company and Provident Life and Accident Insurance Company.
“This action is one of the most significant multi-state insurance regulatory actions in history,” Cline said. “It provides a uniform, verifiable and effective state-based settlement for the benefit of UnumProvident policyholders in West Virginia and nationally.”
The agreements became effective Dec. 20, 2004, with an implementation date of Jan. 19, 2005. Nearly 1,400 West Virginia policyholders will potentially be able to benefit from the agreements.
Policyholders who feel their claims were inappropriately denied can have the claims reassessed under criteria set forth in the agreement. Specifically, the agreement calls for the UnumProvident companies to:
• Offer to reassess claims that were denied or closed since January1, 2000. These claimants will be notified vial mail of this offer and must elect to participate within 60 days from the date of notice.
• If requested, reassess claims that were denied or closed between January1, 1997 and December 31, 1999. These claimants will NOT receive written notice but will be entitled to participate if they so request. Such claimants will have 180 days from the implementation date to request to participate.
• Modify claims handling and benefit determination practices.
• Improve accountability and oversight of claims processing.
“I strongly urge anyone who had a disability claim denied by the subject companies during the past eight years to request reassessment of his or her claims,” Cline said. “Those who have had claims denied or closed between Jan. 1, 1997 and Dec. 31, 1999 need to contact UnumProvident on or before July 16, 2005 to be eligible to have their claims reassessed.”
The complete examination report, settlement agreements and exhibits are available online at www.maineinsurancereg.org, www.state.ma.us/doi, or www.state.tn.us/commerce. UnumProvident claimants can contact the company at www.unumprovident.com or call toll free 1-866-278-4641.