Missy Clyne Diaz  |  October 13, 2014

Category: Labor & Employment

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Unum disabiliy insurance problemsA Unum disability claim denial lawsuit was filed by a Texas woman against Unum Life Insurance Company of America, accusing the company of wrongfully stopping her disability payments despite a disabling traumatic brain injury suffered in a car crash.

Plaintiff Jane Herring is one of thousands of people who have filed insurance claim denial lawsuits against Unum, the largest disability insurance carrier in the nation, for unfairly denying or wrongfully terminating legitimate insurance claims to boost company profits. Unum has long been accused of making payment decisions based on its bottom line.

In addition to thousands of individual claim denial lawsuits, the company’s practices have resulted in a multi-state investigation into Unum — formerly UnumProvident — as well as a Unum/UnumProvident class action lawsuit investigation to research all claims of Unum benefit denials. Unum has been reprimanded for refusing to consider medical opinions of outside physicians, something a court found to be illegal.

Herring worked as a business services manager at a Texas hospital before a car crash on Halloween 2010 left her fully disabled. Unum paid Herring’s disability claim for three years before the company made an allegedly “arbitrary and capricious” decision to terminate the benefits. She alleges Unum’s actions constitute an “abuse of discretion.”

Her insurance claim denial lawsuit alleges that the “reviewing professionals” are Unum employees and are thus beholden to the company, impairing their ability to provide an objective opinion of her condition and abilities.

In 2002, CBS News aired an expose into Unum’s business practices, speaking with more than a dozen former employees, including senior executives, who confirmed that management pressured claim handlers to deny new claims and shut down existing ones to meet monthly targets and increase profits.

The employees said they were rewarded with bonuses. It did not matter if the claimant was truly disabled or if the case file could be terminated based on a technicality. The goal was to beef up profits, according to the employees.

Plaintiffs have had success in insurance claim denial lawsuits against Unum, which has some 40 percent of the disability insurance policy market. Jurors awarded a urology surgeon with disabling ankle pain $1.5 million after finding Unum unfairly denied the claim, and an eye surgeon unable to operate after being diagnosed with Parkinson’s disease was awarded $36 million after being denied.

In general, Unum lawsuits are filed individually by each plaintiff and are not class actions.

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