Disability Insurance Lawyer Direct Talk: Self-Occupation Disability Insurance Policies

Own occupation disability insurance policies

A “Self-occupation” definition of total disability means the inability to work in your usual occupation, that is, to perform the material and substantial tasks of your occupation. Under this definition, total disability means the inability to work in your occupation. The definition of “Own Occupation” is favorable to you, the insured. The Own Occupation definition recognizes that the loss of a regular occupation generally results in a drastic drop in income, even if other employment can be found.

In the 1980s, many disability insurance companies wrote “own-occupation” policies because they were aggressively investing premiums in the stock market. Which, of course, turned out to be a bad business decision. Many of these “Own Occupation” disability policies were sold to professionals: doctors, lawyers, etc. The following saga is evidence presented and proven in recent Federal Court decisions involving Unumprovidident, Unum and Paul Revere.

Unumprovidident, Unum and Paul Revere: a change in the claims process

In the early 1990s, defendant UnumProvident realized that the claims made on the self-occupation insurance policies it sold were putting the company at risk. As a result, the company underwent a major restructuring of its claims handling practices and philosophy. Provident went from being a company that had a claims pay philosophy to one that had a claims “management” philosophy. The results were amazing. Unfortunately, the doctors and lawyers who purchased these disability policies for “peace of mind” received anything but “peace of mind” when they suffered from occupational disabilities.

Provident was not the lone wolf insurer facing financial difficulties due to poor product design, excessive marketing, and underwriting of its own occupational disability insurance policies. There were other disability insurance companies facing similar problems. Many of these insurance companies have exited the disability insurance business. Paul Revere was one of the other large disability insurance companies that had also promoted, marketed, and sold “own-occupation” individual disability products. Paul Revere also found big financial problems with self-occupancy policies and, in response, changed his claims 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, the Provident Companies, Inc. merged with Unum to form UnumProvident.

In 1998, Provident Companies, Inc. and Revere entered into a General Service Agreement. Under the General Services Agreement, Provident, and later UnumProvident, assumed full responsibility for handling Revere’s claims.

Before both the merger and the General Services Agreement went into effect, Provident controlled Paul Revere’s claims handling processes. Transition teams were formed. They drafted “best practices” that the combined entities were required to follow and comply with. In 1996, Provident trained Revere field investigators in these “best practices.”

Which included a claim objectification process that Provide had initiated. Then the claims denial “roundtable” process was started at Paul Revere even before the merger was complete.

The Unum Bad Faith saga continues

This is just one chapter in the continuing saga of Unumprovidident, Unum, and Paul Revere. The evidence firmly establishes a corporate scheme to increase profits without regard to the rights of its disabled policyholders: the doctors, lawyers and others who had purchased Self-Occupation disability insurance. Furthermore, the evidence establishes Unumprovidident, Unum and Paul Revere. he benefited immensely from his misconduct. The results of these companies’ Bad Faith Disability Insurance practices have been devastating for many, many policyholders. Instead of buying “peace of mind” – – until a number of doctors, lawyers and professionals have faced financial ruin.

If your self-employment disability claim has been denied by these companies, you are strongly encouraged to seek legal representation. A good Disability Claims Lawyer can make all the difference for you and your family in “peace of mind.”