As Debra Potter was beginning to encounter problems with UnumProvident in 2002, a federal court jury awarded Joan Hangarter, the Berkeley chiropractor, a $7.6-million judgment against the firm -- an amount it could award only because Hangarter's was an individual policy, rather than an ERISA-covered group policy.
A federal magistrate followed up with an injunction prohibiting the insurer from "targeting categories of claims or claimants [for termination], employing biased medical examiners, destroying medical reports, and withholding ... information."
Six weeks ago, the U.S. 9th Circuit Court of Appeals upheld the jury award, although not the injunction.
In Kevin Murphy's case, it took the cancer patient and former New York textile executive nearly one year, and the hiring of a lawyer, to get UnumProvident to restore his benefits, but it did so last summer. Sabourin recently acknowledged that the insurer had made a "flat-out mistake" in switching off Murphy's benefits.
As for Ricky D. Hart, the North Carolina chicken plant mechanic, UnumProvident acknowledges in documents that he has coronary heart disease. But in a letter last month, it said that it was cutting off his disability checks after an independent medical exam paid for by the company concluded that Hart could still work a 40-hour-a-week desk job and "should not have any problems in operating heavy machinery." It suggested that he exercise.
Liberty Life, the company that denied former Steelcase employee Nancy Loucks' benefits, agreed to pay her an undisclosed sum this spring in return for her joining the company in asking the federal judge in the case to vacate his "caveat emptor" ruling against the firm. The judge agreed, but not before the ruling went down in the lawbooks.
In May, Broadspire Services was supposed to notify former Ohio utility manager Kristin Deskins whether it would reverse itself and restore her employer-provided disability benefits. Broadspire seemed to be in a bind.
Along with specialists who assist people in applying for government benefits, it had helped Deskins win Social Security coverage on the basis that she was totally disabled, only to turn around and claim that her employer-provided plan need not pay because she was not totally disabled after all.
But instead of extricating itself from this dilemma, Broadspire said in a May 26 letter that it had lost most of Deskins' paperwork. She would have to file her request for restoration of benefits all over again.
Broadspire refused to comment on Deskins' case.
Preparing for a day when she will no longer be able to walk, Debra Potter and her family sold their house in December and moved into a new one, where the living area is all on one floor, the bathrooms have grip bars and the halls are wide enough for a wheelchair.
Potter makes it to her husband's Sunday service at the Sunnyside church, where the sign outside reads "Exercise daily and walk with God." But because of stiffness and exhaustion, she often has to be carried out.
On July 15, a letter arrived from UnumProvident. It said that Potter's disability benefits had been approved. It did not include an apology for the three years and one week that she had to wait, or anything extra to pay the lawyer she had to hire.
But it did include this warning: "We may investigate your claim at any time.... [We] may have you examined ... by specialists of our choice.... We may deny or suspend disability benefits if you fail to
