Amanda Antell  |  July 7, 2015

Category: Consumer News

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Disability insurance form with glasses and ballpoint pen.A retired rehabilitation employee is suing Unum Life Insurance Company of America, for allegedly denying her disability benefits.

Plaintiff Mary T. claims in her disability insurance lawsuit that Unum denied her disability benefits for no logical reason and states that the defendant had no evidence to support their decision.

Unum Life Insurance Company is the largest and oldest disability insurance provider in the United States, serving over 17 million Americans. Unum has become the subject of many claim denial lawsuits and legal inquiries for allegedly practicing bad faith insurance.

Bad faith insurance is the act of an insurance company acting in the best interest of itself, rather than their policyholders by looking for any excuse to deny their claims. Several Unum policyholders have reported that this insurance company uses unfair or illegal tactics to discredit their claim, including:

  • Changing policies after claims are filed, without telling policyholders
  • Having third-party medical experts misread medical records
  • Refusing to acknowledge the policyholder’s disability
  • Arguing that the policyholder had a pre-existing condition

Overview of Claim Denial Allegations

Previously, Mary had been fully employed by Reliant Rehabilitation for a number of years before having to retire after becoming disabled. Through her employment, Mary had been provided both long-term disability benefits and waiver of life insurance premiums (LWOP). Both of these policies would have ideally been enacted when the plaintiff needed them.

Under the terms of the premiums and the policy, Mary had met the requirements to receive long-term disability benefits after being diagnosed with a debilitating medical condition. Her doctor stated that she would no longer be able to perform her occupational duties and would have to cease working to prevent her condition from worsening.

Additionally, her doctor stated that she would no longer be able to work in similar positions and her financial records indicate that she has lost a significant portion of her income. Furthermore, her doctor confirmed that this was not a pre-existing or self-induced condition and will only get worse overtime.

Despite meeting all requirements for Unum’s long-term disability benefits and life insurance premiums, Unum denied the plaintiff her long-term disability and premium benefits, according to the disability insurance lawsuit.

The Unum lawsuit indicates that Mary followed all administrative procedures, met all deadlines, and submitted all necessary paperwork. Even when Mary’s claim was initially denied, she responded by following the appeals process and also met all appropriate deadlines. Mary had also submitted additional medical testimony from her physician to further prove the necessity of these benefits.

Despite following all the defendant’s policies, and being considered disabled under Unum’s policy rules, Mary claims in her disability insurance lawsuit that Unum had operated under bad faith when denying her benefits, and that the defendant’s decision to deny the benefits was a conflict of interest to the plaintiff.

Mary’s claims that Unum had the civil responsibility of providing benefits to faithful policyholders, who have already upheld their sides of the contract by paying the insurance policy fees.

It is important to note that in the denial letter, Unum reportedly failed to identity any information or material that supports Unum’s decision, and allegedly used either unqualified or biased research records.

This Unum Claim Denial Lawsuit is Case No. 2:15-cv-00807-JRG-RSP, in the U.S. District Court for the Eastern District of Texas, Marshall Division.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.

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If you were denied a disability claim or had your disability benefits terminated without reason, you may be able to take legal action. See if you qualify by filling out the short form below.

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