A South Carolina woman is suing Unum Life Insurance Company of America for allegedly denying her benefits for no legitimate reason. Spivey claims that Unum practiced bad faith insurance by illegitimately denying her long-term disability benefits.

For years, Plaintiff Judith Spivey was fully employed by Gastroenterology Associates, and was provided long-term disability and life insurance waiver of premium benefits coverage. Essentially, since she was a full-time employee of Gastroenterology Associates, she was entitled to the benefits listed under her plan.

In May 2013, Spivey alleges she could no longer work due her worsening health conditions. According to the bad faith insurance lawsuit, she filed her claim for long-term disability insurance benefits and submitted all required testimony and documents by the designated deadline.

Along with being the insurance provider for Spivey’s plan, Unum is also the sole entity responsible for accepting or denying her claim, according to the Unum lawsuit.

This means that Unum alone had the power to determine whether or not Spivey would receive the benefits she desperately needed. Ever since her conditions worsened, she has had to cease working and has been unable to earn sufficient income on her own. Despite the importance of these benefits for the Spivey, Unum denied her claim.

According to the Unum disability insurance lawsuit, Spivey had followed all administrative procedures when initially filing her claim, and did so when she filed for appeal. She submitted additional medical testimony from her doctor, vouching that she could not sufficiently work because of her condition. Once again, Unum denied Spivey’s claims, stating that she was not eligible for the benefits she was seeking.

At this point, she has exhausted all administrative remedies and has repeatedly pleaded with Unum to reconsider its decision. Spivey alleges that Unum deliberately ignored relevant medical evidence that proved its client’s condition, and that there was more of a financial gain of denying her benefits. Furthermore, she claims Unum relied on biased statements that they had complied in this case, which had allegedly been from third-party medical reviewers.

Spivey is filing the Unum lawsuit for wrongfully denying her benefits, and for allegedly using bad faith insurance practices to deny her claim. Spivey’s attorneys state that Unum and other insurance company has the civil responsibly of giving a full, fair, and complete review of all the claims they receive from policy holders, because its clients rely on the benefits they are supposed to provide.

This Unum Disability Insurance Lawsuit is Judith A. Spivey v. Unum Life Insurance Company of America, Case No. 6:14-cv-03586-HMH, in the U.S. District Court of South Carolina, Greenville Division.

Overview of Unum Claim Denial Tactics

Unum Life Insurance Company is the largest and oldest insurance company in the United States, and provides more disability insurance across the world than any other insurance provider. It currently has over 17 million policy holders in America and 25 million worldwide. Despite its prominent place in the market, this company has been repeatedly criticized for how it processes disability claims.

For years, rejected policyholders have claimed that Unum and other major insurance companies have used bad faith insurance practices to deny them coverage, no matter how vital the need. Ironically, Unum has been most commonly accused of selecting cases that do not appear to be life-threatening or serious, and then dismissing them by illegally using third party opinions or using a legal technicality listed in the policy.

Other bad faith insurance tactics Unum has been accused of using include but are not limited to:

• Making changes to the plan without the authorization of the policyholder
• Changing policies after the policyholder’s claims are filed
• Failing to notify the recipients about these changes
• Improperly and inappropriately investigating a claim
• Obtaining opinions from unqualified third parties
• Having contract medical examiners read over and misinterpret medical records
• Using these third-party medical examiners to deny a claim when the policyholder did not provide a medical exam, or giving the policyholder insufficient time to obtain a medical exam