Is your medical condition a target for insurance companies?

In 2002 Unum’s management decided they had paid long enough on 9/11 victim claims and began “target projects” to review all victim claims and deny as many as possible. I know this because I was charged with exactly that objective.

Those who were injured or affected by the 9/11 tragedy were typically Wall Street Analysts, Morgan Stanley and Mercantile employees with extremely high benefit amounts. Unum’s “target” strategy was to compel claims handlers to “present” all claims at roundtable so that management could decide not only which claims were to be denied, but when. Most mental and nervous 9/11 claims were denied at that time…

Top ten of most frequently targeted disability claims are: Fibromyalgia, Chronic Fatigue Syndrome, Chronic Pain, Lyme Disease, failed Cervical or Back Surgeries, HIV/AIDS, early Multiple Sclerosis, Depression, Anxiety, and PTSD and Migraines. This list is not exclusive to Unum but I find many other insurers are reluctant to pay for certain claims. Secondary non-compensable impairments include Sjogren’s, TMJ, concussion syndrome, connective tissue disease, and POTS.

Improvements in pharmaceutical treatments for HIV have also encouraged Unum’s medical reviewers to allege HIV/AIDS infected insureds can return to work despite a long list of continued symptoms not alleviated by medications that improve T-cell counts. Therefore, over the last several years there is some indication that Unum, like the 9/11 victims, is conducting projects to eliminate as many HIV claims as possible…

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