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Trial Against Unum Over Handling of Disability Insurance Claims Opens Today

by PR Newswire - Sep 23,2008

BOSTON, Sept. 22 /PRNewswire/ -- Trial begins today in federal district court in Boston against insurance giant Unum Group (NYSE: UNM - News) on whether Unum is dumping tens of thousands of disability claims onto the overburdened Social Security system, costing the government millions of dollars.

The court is hearing a "qui tam" lawsuit brought by a whistleblower on behalf of the federal government involving Unum's alleged practice of requiring claimants to file first for Social Security Disability Insurance benefits even when they clearly didn't qualify. If they didn't apply to Social Security, Unum would cut their benefits.

Social Security has much stricter criteria for disability benefits than private insurers. To qualify for disability payments from private insurers, people must be unable to perform their current job; to qualify for Social Security benefits, a claimant needs to be unable to work at all.

"Our lawsuit exposes a practice that creates additional burden on an already overwhelmed Social Security program and also hurts taxpayers," said Colette G. Matzzie, a Washington, D.C., attorney with Phillips & Cohen LLP, which represents the whistleblower. "We're confident that the court will find merit in our case."

Unum lost a request for summary judgment to dismiss the case last week.

"An open door to claimants who are unsure that they are eligible does not exonerate an insurer that knowingly causes ineligible insureds to apply as part of a fraudulent course of conduct," U.S. District Judge Patti B. Saris said in her Sept. 15 decision to allow the case to continue to trial.

The trial is expected to last about four weeks. The qui tam lawsuit was filed under the False Claims Act, which allows private individuals to sue companies for fraud and recover funds on the government's behalf. Companies found to be liable must pay three times the government's losses and $11,500 for each false claim.

As a result of this lawsuit and a New York Times story that looked into the way private insurers handle disability claims, the U.S. Senate Finance Committee is investigating the matter. Sen. Charles Grassley (IA-R) sent a letter in July to nine insurers asking for detailed information on how they handle disability claims.

For more information about Phillips & Cohen, its cases and qui tam lawsuits, see http://www.phillipsandcohen.com .

Case citation: U.S. ex. rel. Patrick Loughren v. Unumprovident Corp., 03-11699, U.S. District Court, District of Massachusetts (Boston).

Source: Phillips & Cohen LLP

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Copyright © 2008 PR Newswire. All rights reserved.

 

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