Insurance Companies

Click on the Insurance Company listed below to read more.

UNUM GROUP

The Unum Group is a general business corporation operating in the United States and the United Kingdom.

In the U.S., Unum’s main subsidiaries include Unum Life Insurance Company of America, Provident Life and Accident Insurance Company, The Paul Revere Life Insurance Company, and the Colonial Life and Accident Insurance Company.  Unum is the largest disability insurance carrier in the United States.

Unum offers individual disability insurance policies, employer-provided (employer-sponsored) and employee-paid group benefits, long-term care insurance, life insurance and other products.

Unum has had some legal problems.  In 2004, former New York Attorney General, Elliot Spitzer and New York Insurance Superintendent, Gregory V. Serio announced that they and several other state regulators reached a landmark settlement with UnumProvident Corporation and five of its subsidiaries – Unum Life Insurance Company of America, The Paul Revere Life Insurance Company, Provident Life and Casualty Insurance Company, Provident Life and Accident Insurance Company, and First Unum Life Insurance Company.

The settlement resolved issues relating to investigations in UnumProvident’s claims handling practices conducted by the New York State Attorney General’s office and the New York State Insurance Department, as well as state insurance regulators conducting a multi-state examination led by Massachusetts, Maine and Tennessee on behalf of all the other states and the Department of Labor.  Allegedly, UnumProvident inappropriately denied claims for benefits under the individual and group long-term disability insurance policies.

The settlement required UnumProvident and its subsidiaries to:

  • reassess approximately 200,000 claims that they originally denied;
  • completely restructure their claim handling procedures to insure objectivity and fairness; and,
  • pay a $15 million fine.

CIGNA CORPORATION

CIGNA Corporation is a publicly held corporation in the United States.  CIGNA and its subsidiaries provide healthcare and healthcare-related products primarily through the workplace.  These products include group disability insurance, life and accident insurance, and workers’ compensation case management as well as other services.

CIGNA has five business segments: Healthcare, Disability and Life, International, Run-off Reinsurance and Other Operations.  Early in 2010, CIGNA acquired Kronos Optimal Health Company.

CIGNA has had some legal problems.  In February of 2009, after a year-long investigation revealed that the health insurance industry relied on a defective database from Ingenix to help set rates, New York Attorney General, Andrew Cuomo secured an agreement with WellPoint, Inc, CIGNA and other carriers to sever their relationship with Ingenix.  Cuomo’s investigation focused on allegations that as a subsidiary of UnitedHealth Group, Inc. (one of the insurance carriers involved in using the defective database),Ingenix had a vested interest in helping set rates low so that the insurance companies using Ingenix’s defective database could underpay patients for out-of-network services.  The investigation uncovered that the database used by Ingenix intentionally skewed “usual and customary” rates downward through faulty data collection, poor pooling procedures, and a lack of audits – forcing consumers to pay more than they should.  The insurance carriers being investigated, including CIGNA, ultimately had to pay a combined $90 million towards the establishment of an independent, non-profit organization to create a new database.

SUN LIFE FINANCIAL

Sun Life Financial, Inc. is an international organization incorporated in Canada.  Sun Life Financial , Inc. offers both consumers and corporations life insurance, health insurance, savings investment management, retirement and pension products and services.

Sun Life Financial, Inc. operates through five business segments: Sun Life Financial Canada, Sun Life Financial United States, MFS Investment Management, Sun Life Financial Asia and Corporate.

Recently, a disabled woman filed a lawsuit against Sun Life.  The suit alleges that Sun Life violated the State of Michigan’s insurance reforms relating to disability insurance contracts.  They are seeking class action status: individuals who were covered by Sun Life for short and long-term disability insurance after June 1, 2007, whose plans contained “discretionary proof” clauses, and whose claims were denied.

The goal is to overturn denied claims and force Sun Life to compensate policyholders for their lost benefits.

FORTIS INSURANCE COMPANY

Fortis Insurance Company is based in The Netherlands.  Fortis Insurance Company offers corporations and consumers non-life coverage, healthcare and disability insurance as well as mortgage and savings products.

Fortis Insurance Company’s non-life insurance products include motor, fire and liability insurance, workers’ compensation and accident and health products.

AXA EQUITABLE LIFE INSURANCE COMPANY

The AXA Equitable Life Insurance Company was established in 1859.  AXA Equitable Life Insurance Company offers life insurance annuities and investment products and services to corporations and individuals.

Recently, AXA Equitable Life Insurance Company was charged with violations by the New York Insurance Department for making inaccurate or incomplete disclosures to consumers buying replacement annuity contracts and life insurance policies.  AXA Equitable Life Insurance Company was ordered to pay a fine of $1.9 million.

GUARDIAN LIFE INSURANCE COMPANY OF AMERICA

The Guardian Life Insurance Company of America is headquartered in New York City.  Guardian Life Insurance Company and its subsidiary, Berkshire Life Insurance Company of America, offer life insurance, disability insurance, health indemnity insurance and retirement plans.

Guardian Life Insurance Company of America has had some legal problems.  In February of 2009, after a year-long investigation revealed that the health insurance industry relied on a defective database from Ingenix to help set rates, New York Attorney General, Andrew Cuomo secured an agreement with WellPoint, Inc,, Guardian Life Insurance Company and other carriers to sever their relationship with Ingenix.  Cuomo’s investigation focused on allegations that as a subsidiary of UnitedHealth Group, Inc. (one of the insurance carriers involved in using the defective database),Ingenix had a vested interest in helping set rates low so that the insurance companies using Ingenix’s defective database could underpay patients for out-of-network services.  The investigation uncovered that the database used by Ingenix intentionally skewed “usual and customary” rates downward through faulty data collection, poor pooling procedures, and a lack of audits – forcing consumers to pay more than they should.  The insurance carriers being investigated, including Guardian Life Insurance Company, ultimately had to pay a combined $90 million towards the establishment of an independent, non-profit organization to create a new database.

The attorneys at DeHaan Busse LLP . . .

have successfully litigated cases against some of the largest insurance carriers in the field including UnumProvident Corporation and its subsidiaries, CIGNA, Sun Life Insurance & Annuity Company of New York, Guardian Life Insurance Company of America, Fortis Insurance Company, AXA Equitable Life Insurance Company of America, Metropolitan Life Insurance Company, New York Life Insurance Company, First Reliance Standard Life Insurance Company, The Hartford Life Insurance Company, Berkshire Life Insurance Company of America, Aetna Life insurance Company, and Life Insurance Company of North America, among many others.

Should you or anyone you know need assistance with a long-term disability claim, contact DeHaan Busse LLP at: 631-582-1200.

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