Health firm seeks way to settle claims

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The Independent Online
THE PERMANENT health insurer UNUM, whose policies pay an income to those unable to work through illness, is seeking new methods of resolving disagreements with claimants, writes Christine Stopp.

UNUM has been the subject of a number of press reports, mainly about claimants who allege their benefit was unreasonably withdrawn. In 1991, a Staines policewoman was awarded damages of pounds 45,000 against the company, then known as NEL. Last December, a Scottish court awarded a man pounds 40,000-plus in benefits and damages. More recently a former photographer settled for back-payments of pounds 50,000 and reinstated benefits of pounds 27,000 a year.

UNUM is now exploring ways of dealing with disputes. It has set up an in-house team to deal with them, run by staff unconnected with the original decision to refuse or rescind a claim.

The 30-member claimants' support group reports that the company has asked three claimants to accept arbitration by James Haswell, a former insurance ombudsman, but in all three cases the proposal was rejected by the policy-holders concerned. UNUM confirms that it has been asking Mr Haswell to act as arbitrator 'on an experimental basis'.

Permanent Health Insurance policies are not regulated under the Financial Services Act, and there is no ombudsman system which fully covers them.

About 60 per cent of all such policies are set up by companies on behalf of employees, and such 'group' policies are not usually covered by the Insurance Ombudsman. So at present, the ultimate recourse is to sue.