In addition to the fine, the Georgia Department will require the
companies to make
changes to their claims handling practices and each company will
be placed on probation for two years.
The other companies include Unum Life Insurance Company of
America, The Paul Revere Life Insurance Company, Provident Life
and Accident Insurance Company, and Provident Life and Casualty
Company.
Among other things, the companies agreed:
- That their claims personnel will not overrule medial
opinions relating to the disability status of a claim that is
provided by a more highly trained and/or qualified
professional without concurrence of an equally trained and/or
qualified professional.
- To be sensitive to claims in which a narrow interpretation
of policy provisions or legal principles may lead to an unfair
result.
- To provide improved communications to claimants regarding
denial and the availability of the appeals process.
In addition to the above, UNUM and its subsidiaries agreed to
submit to quarterly reviews by the Georgia Department each
quarter for the next two (2) years.
