Problems with UNUM? Datline Interview

[Guest guest]

.. This is Not the official transcript. If you want an official

: transcript for legal purposes you must contact NBC - just go to

: www.msnbc.com and put the words

: dateline transcript in their search link to get info on that (It's

: at the very bottom of the page.)

The comments come from the webmaster of the " insurance justice " website

:

: ===================================================================

:

: BENEFIT OF THE DOUBT - Wrom: ULHPQQWOYIYZUNNYCGPKYLEJGD

:

: Announcer - From our studios in New York, here is Stone .

:

: STONE PHILLIPS: Good evening. Insurance. We buy it for peace of mind, to

: cover our homes, our health, our lives. And millions of Americans have

: disability insurance to help replace lost income in case of a serious

: illness or injury. If you can't work, those benefits may be crucial for

: you and your family.

:

: But what if suddenly, unexpectedly, your benefits were cut off? That's

: what happened to the people in our first story. Tonight, some startling

: charges against the biggest disability insurance provider in the

: country. Here's Larson with a DATELINE Investigation.

:

: JOHN LARSON reporting: Voiceover - It began on this stretch of

: Interstate 40 in Albuquerque, New Mexico, in February of 1998. A car

: salesman swerves to avoid some rocks, and the world suddenly turns

: upside down.

:

: (Video of car on highway getting into an accident)

:

: Mr. JOHN MONTANO: The nurses and all the physicians they were saying,

: `Do you have any feeling? Can you move your legs?' And--and I kept

: telling them, `I can't feel anything from the chest down.'

:

: LARSON: Voiceover - The accident had severed Montano's spinal

: cord. Although he was spared some limited use of his arms, he's

: considered a quadriplegic, paralyzed for life. And what lay ahead could

: hardly have looked worse. Unable to work or support his family, Montano

: faced losing everything. But like millions of Americans, he had prepared

: for just such a disaster. He had paid $59 a month for disability

: insurance, which promised if he was ever too sick or too injured to keep

: working, it would help replace his lost income. The checks began

: arriving as promised, but after two years, he got a shocking letter.

: His disability benefits were being cut off.

:

: (Video of Montano struggling with disability, and picture of letter from

: UNUM.)

:

: Mr. MONTANO: I was scared and I was frightened. I go, `Well, there's

: got to be a mistake.'

:

: LARSON: But there was no mistake. Montano's insurance company had

: decided that despite his paralysis he no longer deserved benefits. So

: what was going on?

:

: Sources tell DATELINE that what happened to Montano may have been

: part of something much larger. Tonight, a DATELINE Investigation into

: whether the largest disability carrier in the United States,

: UnumProvident, launched a company-wide effort to cut costs aggressively,

: and in the process, unfairly denied benefits, selling out people it

: promised to protect.

:

: Mr. MONTANO: They just basically cut me off and that was it.

:

: LARSON: Voiceover - In Montano's case, Provident claimed to have good

: reason. It said it had surveillance tape that Montano had improved

: immensely and he should go back to work selling cars.

:

: (Video of letter excerpts.)

:

: LARSON: Was there any way that was faking his quadriplegia?

:

: Dr. JONATHAN BURG: Absolutely not. There's no way.

:

: LARSON: Voiceover - Dr. Burg is Montano's doctor.

:

: (Video of Dr Burg talking to reporter - Burg examining x-rays)

:

: Dr. BURG: This is the area of his--basically the area of his paralysis.

:

: LARSON: Voiceover - He says the records are clear, Montano is a

: quadriplegic.

:

: (Burg describes x-rays)

:

: LARSON: Did you tell the company, `Look, I'll take any test you want me

: to take?'

:

: Mr. MONTANO: Yes.

:

: LARSON: And so did they do that? Did they evaluate you?

:

: Mr. MONTANO: No, they--I didn't hear back from them.

:

: LARSON: Voiceover - The disability and life insurance industry says it

: faces one and a half billion dollarsin fraudulent claims every year. So

: you can understand why it might investigate Montano's claim. But when

: UnumProvident finally shared its surveillance tape, Dr. Burg says it

: showed nothing new. Just Montano driving his specially-equipped

: van, demonstrating what everyone already knew. Montano had a limited use

: of his upper arms. In a letter to UnumProvident, Dr. Burg stated, " by

: all standards this man is completely and totally disabled. "

:

: Meanwhile, his benefits cut off, Montano spiraled towards bankruptcy.

: His wife had divorced him after the accident. Now, faced with losing

: his home and his children, he says he became suicidal.

:

: (Videos of Montano driving his van, and later struggling with his

: disability.)

:

: LARSON: It sounds like it was pretty close.

:

: Mr. MONTANO: Yeah. Yeah.

:

: LARSON: Voiceover - So how could something like this happen? These

: people say they know.

:

: (Video of Montano talking to reporter - people talking to reporter from

: darkened room)

:

: Unidentified Man no. 1: They have to literally fight to get their

: benefits.

:

: LARSON: Voiceover - These three former UnumProvident employees tell a

: disturbing story of a company obsessed with finding excuses to cut off

: benefits.

:

: (Video of people in the dark talking to reporter and of UnumProvident

: building)

:

: LARSON: Did you feel pressure to deny claims?

:

: Unidentified Man no. 2: Absolutely.

:

: LARSON: They asked DATELINE to conceal their identities because they're

: afraid of reprisals.

:

: Man no. 2: Find ways to close the claim. Just look so very carefully to

: find anything that will disqualify them from claim.

:

: Man no. 1: They even gave incentives.

:

: LARSON: Incentives how?

:

: Man no. 1: Incentives for closing claims. If we projected that we're

: going to close 30, if we get to 30 we'll have a pizza party or we'll

: have an ice cream party.

:

: LARSON: Voiceover - Would the company pressure employees to terminate

: claims? Financial reports show that in 1993 the company was losing

: millions. Then came new management and a complete reversal. It began

: making millions. How did they do it? UnumProvident says by

: restructuring and making smart business decisions. But internal

: documents suggest the company had a new game plan to help it deny as

: many claims as it could.

:

: (Video of UNUM building, their net income, and " confidential documents " )

:

: Offscreen Voice from video - Would you raise your right hand, please.

:

: LARSON: Voiceover - This man, Dr. Feist, was one of

: Provident's two staff physicians when new management took over in 1993.

: He left the company two years later. Here in a deposition, he describes

: under oath how the company changed.

:

: (Video of Feist being deposed.)

:

: Dr. WILLIAM FEIST: (from deposition) There was no concern for the

: individual. It was just bottom line. `If we can terminate this file,

: we're going to do it.'

:

: LARSON: Voiceover - Dr. Feist says the company first began targeting

: the policyholders who were costing the company the most money at

: meetings called " round tables. "

:

: (Feist videotaped deposition - UnumProvident building)

:

: Dr. FEIST: (From video) The object of the round table was to cut off the

: high-dollar claims.

:

: LARSON: Voiceover - UnumProvident urged DATELINE not to believe Dr.

: Feist, saying his knowledge of the company is " outdated, " and that he

: has twice signed affidavits which included false information. Dr. Feist

: says they were simple mistakes. And remember, Dr. Feist is not the only

: one speaking out.

:

: (Video of UnumProvident letters - Feist videotape deposition - people

: in shadows talking to reporter)

:

: Unidentified Man no. 3: It became a witch hunt.

:

: LARSON: Voiceover - These people say they encountered similar round

: tables years later.

:

: (People in shadows talking to reporter)

:

: Man no. 3: It was all looking for loopholes to close the claim.

:

: LARSON: `And if you can't do it, we'll have a team of experts here to

: figure out how you can.'

:

: Man no. 1: It was mandatory. Even if you didn't have a claim, you'd

: better find one.

:

: LARSON: Voiceover - They say most vulnerable were policyholders with

: so-called " subjective illnesses, " illnesses that don't show up on x-rays

: or MRI's, like mental illness, chronic pain, migraines or even

: Parkinsons.

:

: (MRI scans and x-rays)

:

: Man no. 1: `So they're fatigued. Prove it.' `So they've got achy

: joints. Prove it. Why can't they work?'

:

: LARSON: And if they can't prove it?

:

: Man no. 1: They're out of there.

:

: LARSON: Denied.

:

: Man no. 1: Denied.

:

: LARSON: And they are not the only ones saying this. In all, 10

: UnumProvident employees agreed to speak with DATELINE, but only if we

: promised not to reveal their names. We can tell you this about them:

: their jobs range from claim representatives all the way up to vice

: presidents. Some left the company on their own, some were fired, and

: some still work at UnumProvident. But all have described the same

: atmosphere, one of intense pressure coming from management, down to

: employees. Pressure to cut off benefits to policyholders.

:

: Voiceover - DATELINE also searched thousands of pages of internal

: corporate documents and court records and found evidence that appears to

: back up what they say. This is a series of internal monthly reports

: that show company savings seem to be growing--the result of cutting

: claims. " Terminated claims have reached a record level. "

:

: And, we found evidence that suggests the company set goals for cutting

: claims, deciding ahead of time how many claims should be denied. Like

: this 1995 top-level memo. It spells out a company-wide goal to

: terminate $132 million in claims. Here, an internal e-mail from last

: year alerting a group of adjusters they have one week to close 18 more

: claims to meet our projections. These people say if they didn't meet

: their projections, they'd have what they called " fire drills, " intensive

: efforts to find claims to close.

:

: (Stacks of papers and memos - emails - people in shadows talking to

: reporter - files)

:

: LARSON: The image is of a fire drill, a bell goes off, and everybody

: rallies to a cause. What was the cause?

:

: Man no. 3: The cause was looking for opportunities to close a file.

:

: LARSON: Deny claims.

:

: Man no. 3: Deny claims.

:

: LARSON: Voiceover - UnumProvident would not agree to an on-camera

: interview, but vehemently denies that it sets goals to terminate claims.

: In a letter to DATELINE, it says it does " estimate claim results to

: project a business plan into the future, " which may have been

: " mischaracterized or misinterpreted by others. " Also, it says that it

: will pay $3.6 billion in benefits this year. And that of all the people

: who filed claims with UnumProvident last year, only 2 percent were found

: to be not disabled. And, it says it has a consistent record in paying

: claims.

:

: UnumProvident is more than just claims people and managers. It's also

: doctors, over 100 of them, doctors sworn to do no harm. Wouldn't a

: UnumProvident doctor stop the company from cutting off disabled people?

: Not according to this policy holder.

:

: (Exerpts from letters)

:

: If I could have every wish in the world, I'd--I'd wish that I could

: teach again and see my kids get older. Two wishes.

:

: LARSON: Voiceover - Once a healthy, vibrant school teacher from

: Illinois, Rosemary began suffering from a progressive, fatal form

: of emphysema. Even the smallest activity can leave her gasping for

: breath.

:

: Her doctors say the kind of emphysema has is genetic, it's not

: from smoking. The same disease had already killed her younger brother,

: and now it's killing her. When became too sick to teach,

: UnumProvident began paying her disability benefits. But two years

: later, just as in Montano's case, the company cut her off.

:

: (Photos of Rosemary - making bed, pausing to catch breath

: - photo of man - - taking medicine from inhaler)

:

: Ms. WRIGHT: I opened that letter, and I couldn't believe it. I thought,

: `Why? I mean, this must be a mistake.'

:

: LARSON: Voiceover - UnumProvident based its decision on the opinion of

: a UnumProvident staff doctor who not only never examined in

: person, but disregarded the opinions of 's two doctors, both lung

: specialists who had examined her and found her totally and completely

: disabled.

:

: So how could a UnumProvident doctor help cut her off? Dr. Fergal

: McSharry, who doesn't know Rosemary , worked for UnumProvident for

: a year and a half. He says it is more about the system than the doctor.

:

: (UnumProvident building - UnumProvident letter - excerpt from letter -

: letter from Arizona Pulmonary Specialists, Ltd. - excerpt from letter -

: UnumProvident building - Fergal McSharry)

:

: LARSON: Doctor, were they interested in your honest, objective medical

: opinion?

:

: Dr. FERGAL McSHARRY: No.

:

: LARSON: Voiceover - McSharry says doctors at UnumProvident were

: pressured to write narrow medical reports to help the company deny

: benefits.

:

: (UnumProvident building)

:

: Dr. McSHARRY: We were a means to an end.

:

: LARSON: And the end was?

:

: Dr. McSHARRY: The end was denial.

:

: LARSON: Voiceover - And if too many of their opinions favored the

: claimants, McSharry says doctors would be reprimanded, in his case, by

: his boss.

:

: (UnumProvident building)

:

: Dr. McSHARRY: I was told that I'd fallen off the career path.

:

: LARSON: What did you feel you had to do to get back on their career

: path?

:

: Dr. McSHARRY: You know, I was just going to have to do more of what the

: claims people wanted me to do, which was...

:

: LARSON: And what was that?

:

: Dr. McSHARRY: That was to make it easy for them to deny the claim.

:

: LARSON: Voiceover - Dr. McSharry says, like other doctors who work at

: UnumProvident, he succumbed to the pressure.

:

: (McSharry talking to reporter)

:

: LARSON: Did you ever change a medical opinion because you were being

: pressured?

:

: Dr. McSHARRY: Yes. I did.

:

: LARSON: These were cases where, in your best medical opinion, you

: thought these people were either sick or impaired or disabled. You

: reversed your own best judgment?

:

: Dr. McSHARRY: Um-hm. I did that. I didn't want to lose my job. I

: didn't want to upset everybody around me, and I tried to play within the

: rules.

:

: LARSON: Voiceover - McSharry says he did it only a couple of times and

: vowed never to do it again. Even so, if what he's saying is true, they

: got his medical soul.

:

: (McSharry talking to reporter)

:

: Dr. McSHARRY: Yeah. I'm only human. I--I had--you know, I--I gave in

: once or twice. I just hope I didn't hurt somebody too--too badly.

:

: LARSON: Voiceover - UnumProvident says it doesn't pressure doctors to

: terminate claims. So what happened to Dr. McSharry? He was fired from

: UnumProvident for what the company calls " poor performance. " It also

: says Dr. McSharry was forced to resign from other jobs for similar

: reasons.

:

: But McSharry says that losing those other jobs had nothing to do with

: his performance, and the real reason he was fired from UnumProvident was

: that he began standing up to the company, refusing to play along. In

: fact, five of DATELINE's sources back up Dr. McSharry's story.

: Specifically, that doctors were pressured to help cut off benefits. Dr.

: McSharry is now suing UnumProvident.

:

: (Video McSharry talking to reporter and excerpts from letters)

:

: Dr. McSHARRY: I don't have a problem with people setting targets as long

: as those targets are reasonable and don't hurt people.

:

: LARSON: Were these targets reasonable?

:

: Dr. McSHARRY: No, not at all.

:

: LARSON: Did they hurt people?

:

: Dr. McSHARRY: They hurt people every day.

:

: Ms. WRIGHT: They didn't just take the money away from me. But they took

: a sense of dignity away from me.

:

: LARSON: Voiceover - After UnumProvident ended her disability payments,

: Rosemary says she was forced to begin spending money she had

: saved for a lung transplant just to cover living expenses. sued

: the UnumProvident, which suddenly reversed itself, reimbursed her back

: benefits and began paying her again. But has not dropped her

: lawsuit, and says the stress took its toll.

:

: ()

:

: Ms. WRIGHT: I wasn't sleeping. You know, I was a wreck. And yes, last

: year was the sickest year I've ever had. I believe that they robbed me

: of a--of a whole--almost a year of my life.

:

: LARSON: Voiceover - As for Montano, the quadriplegic, he also

: filed suit against UnumProvident and the company settled with him for an

: undisclosed amount of money.

:

: (Montano getting into van)

:

: LARSON: In the end what was this company's promise worth?

:

: Mr. MONTANO: To me, nothing. Their word, the way they operate, they're

: totally unethical.

:

: LARSON: Voiceover - UnumProvident says it regrets how it handled the

: cases of and Montano, but says they're exceptions. It also says

: it handles 400,000 new claims a year and it does on occasion, make a

: mistake. Yet, in the eyes of at least one insurance commissioner, it

: may be more than an occasional mistake.

:

: (Video of UnumProvident letters - excerpts from letters - GA insurance

: commissioner)

:

: Mr. JOHN OXENDINE: There are some substantial problem areas...

:

: LARSON: Voiceover - Georgia Insurance Commissioner Oxendine told

: DATELINE he began investigating UnumProvident's disability practices

: more than a year ago. He says his investigation should be complete by

: the end of the year.

:

: Mr. OXENDINE: Unless something radical changes, there probably will be

: some disciplinary action based on what we have already found.

:

: LARSON: Voiceover - UnumProvident says the problems in Georgia

: represent a small percentage of their overall claims, and it will do

: what is necessary to correct these issues. In the end, both Montano and

: say no one should be treated the way they were treated--cut off,

: abandoned by a company that had promised if the worst ever happened, it

: would be there for them.

:

: (UnumProvident building - and Mr. Montano)

:

: Mr. MONTANO: It's like stealing. They should have - be held accountable

: for that.

:

: ===================================================================

:

: Webmaster comments: How can they have those billions of dollars in

: fraudulent claims if only 2% were denied? Something doesn't add up. I

: could use some real figures to recant UNUM's lies. Oh, here is another

: reader suggestion, along with my response:

:

: From Georgia,

:

: If you haven't already, check out Unum's Co. News about yesterday's

: Dateline story. It is interesting to read the propaganda/lies/spin they

: sent to Dateline. It is a pdf link off to the right side of their damage

: control site...

:

: An Observation: Unum proudly gives the statistic that they approve 90+%

: of their disability claims. That may be true. But how many of these

: initially approved claims are denied down the road? That statistic is

: the more important one and would certainly be interesting to know. I

: wonder if they arbitrarily deny all disability claims after approx. 2

: years (such as they did with the victims on Dateline and such as they

: did with me)...

:

: Webmaster's response: Two years and out seems to be the

: standard. And you can tell a lot of lies with statistics. What if the

: ones they approve are only approved for tiny partial payments for

: instance?

:

: Is there a way all of us could post our reactions to the Dateline

: expose'? I have tried getting on the crimefighters chat board, but no

: one is ever there.

:

: Webmaster's response: Sure, just send them to

: unumhorror@... That will help me sift them out

: and would add some body to the site. We do need some rebuttals of their

: lying " statistics " They should be self-explanatory, citing the original

: lie and the proof against.

:

: Is there a way to have everyone's comments come up automatically when

: we visit the site?

:

: Webmaster's response: No reason it can't be done - it just takes

: time to put them up - sigh. Although if you mean a better bulletin board

: I am working on it. The bulletin board that came with the site is

: obtuse. Overkill. Too complicated. Lousy colors. Which might explain the

: low traffic. I'll try to find a simpler one so maybe it will get more

: usage. I would write one in PHP but it would take too long. Maybe later.

:

: BTW, it may sound goofy for me to refer to myself in the third person,

: but I've found it gets really confusing to readers as to who is speaking

: when I just interject comments. In magazines they can highlight, but

: I've also gotten complaints for straying from plain text into unreadable

: fonts - so I'm sending as plain text, which doesn't allow highlighting.

: But plain text avoids a lot of hassles that are a drawback of fancy HTML

: email. One reason I used plain text so long is it is Impossible to

: transmit a virus to readers using text format. Another is that

: recipients can format the text as they like.

:

: ===================================================================

:

: GETTING SPIRITUAL

:

: I dropped this on some UNUM folks. Some might think it excessive but I

: like to think I was waxing poetic:

:

: The subhuman animals who run UNUM:

:

: They have no conscience.

:

: They have no souls.

:

: They have no beliefs beyond Grab and Get.

:

: They are riding high now, puffed up with arrogance and power, telling

: lies or having their pet PR flacks and legal whores lie for them.

:

: Some day the Dark Man will come for all of them and they will discover

: there is more to life than they think. Not that these evil, greedy

: bastards believe in an afterlife or heavenly punishment for their

: murderous misdeeds.

:

: But it will happen whether they believe it or not - in the dark of

: night. As is the way of All flesh. As will happen to All of us, some day

: the scum who run UNUM won't wake up to the world, but to be either

: rewarded for their kindness or reap the pain they have sowed ... forever

: and ever.

:

: Then they will learn their lesson.

:

: But it will be too late.

:

: Some have already passed that way and I hear their cries from the

: darkness.

:

: Their cries will do no good.

:

: They have had their chance.

:

: Do they really think with all their money and power, that they will live

: forever? They think their victims are naive, but are they that naive to

: not even think of eternity? Their few short years of luxury and theft

: are a poor bargain for what they will suffer afterwards. All their

: riches will not save them. They are fools. They are dead meat. They are

: food for worms and their souls are food for Satan.

:

: And J. Harold Chandler will have a special place in hell. He doesn't

: believe that of course, being an evil man. Nor does he believe that all

: his victims, living and dead, will assemble to bear witness against him.

: Or that the books of his anguish are being marked even now with a

: frightful toll.

:

: But it doesn't matter what he believes.

:

: In the end there is always Justice. The toll will be exacted. The price

: will be paid.

:

: UNdead

: United in

: Misery

:

: ===================================================================

:

: They didn't like my bit of whimsy. Actually, of course, that applies to

: nearly all major insurers - you just have to change the name of the

: company.

:

: Otherwise, UNUM's stock has dropped about two dollars, and that's the

: Only message these folks can hear. It only dropped twenty cents after

: the Dateline special but that's because most of the drop had already

: occurred, anticipating a Sixty Minutes special. Dateline came out of

: left field. We can only hope Sixty Minutes still airs, although

: journalists are competitive and sometimes don't like to follow each

: other with the same story. On the other hand, if UNUM gets Enough

: coverage, there is a phenomenon called pack-journalism that will do them

: no good. Which they do all depends on coverage and how events fall out.

: So let us pray that it falls out badly for UNUM.

:

: ===================================================================

:

: HERE BE BAD GUYS

:

: Welcome to our Web site . . .

:

: http://www.ncoil.com/

:

: The National Conference of Insurance Legislators (NCOIL) is an

: organization of state legislators whose main area of public policy

: concern is insurance legislation and regulation. Many legislators active

: in NCOIL either chair or are members of the committees responsible for

: insurance legislation in their respective state houses across the

: country.

:

: If anyone wants to know why we're in an insurance nightmare, no matter

: what the claim - then check out this website from beginning to end.

: These are the folks who are really responsible for all of our problems.

:

: GOD bless us and help us,

:

: Dina Padilla

:

: Webmaster's Comments: Doesn't this suck? Now these bribed bastards have

: an organization. At first I thought it was a confusion with the NAIC but

: they are so brazen as to announce they are a bought group of whores.

: Gee, I wonder who funds NCOIL. I'll give you three guesses and the first

: two don't count.

:

: NCOIL of course wants to do away with All punitive damages, so insurers

: can break all the laws of God and man with impunity, and make a hefty

: profit doing it. Not only victims, but the legal profession (the good

: ones) need to expose these bums.

:

: ===================================================================

: You can contribute to the Insurance Justice / Corporate Crimefighters

: network with a donation to Jim Mooney - IJ/CCA webmaster, 4867 Irvington

: Av., ville, FL 32210

: ===================================================================

:

: Yours,

:

: Jim Mooney, webmaster: www.corporatecrimefighters.com (for Dr. Judy

: ), and www.insurancejustice.com