A former physician at Duke University Medical Center filed a insurance claim denial lawsuit against long-term disability benefits provider Unum Life Insurance Company.

Dr. Karen M. of North Carolina claims she was forced to stop working as a general practitioner in February 2007 after suffering from peripheral neuropathy, severe cognitive dysfunction and gait disturbance.

Dr. Karen was diagnosed with neurocognitive syndrome, which allegedly makes her completely unable to work as a physician or in any other field.

The Unum lawsuit states that when Dr. Karen filed for long-term disability benefits in May 2007, she received them as planned. However, Dr. Karen says she received notice on July 7, 2009 that her benefits would be abruptly ending because Unum believed her to no longer be disabled. Dr. Karen claims that she appealed the termination but her appeal was denied in December 2009.

In addition to losing her disability insurance benefits, Dr. Karen claims that in October 2010 Unum informed her that she no longer would be receiving her Unum Life Insurance Premium Waiver. The former physician said she appealed that decision as well, but again her appeal was denied.

Not seeing any other option, Dr. Karen claims she was forced to file the Unum lawsuit alleging the insurance company wrongfully denied her disability benefits. Dr. Karen says that Unum did not take into account the evidence of disability she provided to them, but rather the insurance company determined that her medical condition would fall under the mental illness limitations section of her policy.

Dr. Karen’s bad faith insurance lawsuit accuses Unum of denying benefits without reviewing evidence of her disability. The suit also alleges that the insurer intentionally misread her medical records in order to terminate benefits.

The Unum lawsuit seeks financial reimbursement for Dr. Karen for her unpaid disability benefits.

Disability Insurance Denial

Unum Insurance is one of the largest insurance providers in the U.S., with more than 17 million policyholders nationwide. Each month employees insured by Unum deduct a portion of their paycheck in order to pay Unum for disability insurance. In the rare circumstance where they become disabled, they will be able to rely on some income from their insurance policy.  

However, in recent years Unum has faced numerous lawsuits alleging that the company engages in what is referred as bad faith insurance denial.

According to Unum lawsuits, policyholders have experienced the following bad faith practices:

• Misreading medical records in order to deny claims
• Refusing to acknowledge claimants’ disability
• Omitting records to record reviewers when it would show a claimant as disabled
• Changing policies once claims are filed (and without the authorization or knowledge of policy holders)
• Investigations that are performed by biased and sometimes unqualified “experts”
• Claims representatives who take favorable opinions of nurses over physicians when it comes to disability reports

Unum Claim Denial Lawsuit

Dr. Karen is just one of many who have been forced to file an insurance claim denial lawsuit in order to begin receiving disability benefits. In general, Unum lawsuits accuse the company of wrongfully denying benefits by using bad faith practices.

If you were denied Unum disability benefits, contact an attorney to find out if you can file a Unum lawsuit or join a Unum class action lawsuit.