After receiving notice that Unum denied her disability claim, a woman with multiple sclerosis took matters into her own hands and filed a lawsuit against the disability insurance company.

Kimberly was a Creative Director at an advertising group before she became disabled in June 2004. She suffers from multiple sclerosis and she goes through periods of remission and relapsing as a part of her condition.

While the intensity of her symptoms vary, she experiences symptoms daily and they are exacerbated by over-exertion, heat, fatigue and stress.

Under Unum’s long-term disability, Kimberly was considered disabled because she was limited from performing the duties of her regular occupation (what Unum refers to as “own occupation”). She was not required to show that she was disabled from any occupation because she met the “own occupation” criteria.

Unum paid Kimberly for her long term disability benefits for ten years as they received continued updates from Kimberly. However, in December 2014, Unum terminated her LTD benefits.

Following protocol, Kimberly submitted appeal paperwork and materials supporting her continued disability. Despite her efforts, she received a denial to her appeal, exhausting all administrative remedies available through the company.

Kimberly brought forth a claim of wrongful denial of benefits under ERISA against Unum. ERISA stands for Employee Retirement Income Security Act; it was designed to protect employees and their rights to benefits.

Kimberly is seeking reinstatement of her long term disability benefits, payment of benefits that have accrued prior to the judgment, plus interest, reimbursement of litigation expenses, and any other relief as deemed appropriate by the court.

The Unum Disability Denial Lawsuit is Case No. 3:51-cv-00385-FDW-DCK in the U.S. District Court for the Western District of North Carolina, Charlotte Division.

Unum Bad Faith Insurance Denial

Unum seems to have developed a reputation for denying insurance benefits
when claimants appear to be eligible. Some have described this practice as Unum’s way of denying a lot of long term disability claims and waiting to see who continues to push back before any benefits are paid.

Back in the 1980s, Unum was involved in some shady practices that were discovered and brought to light. Unum was involved in selling a lot of life insurance policies without considering the potential future risk of policy holders.

This process is known as cash flow underwriting. There were also reports that suggested that Unum had been investing revenue from life insurance premiums and collected profits from those investments.

When the value of Unum’s life insurance policies declined, Unum started denying benefits to policy holders even when they met eligibility criteria and paid premiums, and it seemed this was almost a universal practice of the company. These types of policies are considered “bad faith insurance.”

Policy holders who have been denied benefits should be sure to take advantage of the appeal process through Unum first. If the appeal is denied, consultation with a Unum attorney is the next best step to take.

Unum Claim Denial Lawsuit Information

If you have a been denied Unum disability insurance benefits and have exhausted your administrative options under your plan, you may have a legal claim. Experienced Unum lawyers can assist you by reviewing your case and discussing your legal options in a free case review.