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Claiming Unum Life Insurance Company wrongfully denied his long-term disability benefits, an Arizona resident has filed a disability claims lawsuit against the company.
After working as a loyal employee of American Family Mutual Insurance, Plaintiff Michael C. became disabled in March 2003 due to serious medical conditions and was unable to work in his designated occupation as a Physical Damage Claim Representative.
Following the onset of his disability, Michael filed a claim for short-term disability insurance benefits which Unum approved and paid.
Upon the exhaustion of these short-term disability benefits, Michael then filed a long-term disability benefits claim under his disability insurance benefits plan under Unum.
In support of his long-term disability claims, Michael submitted to Unum medical evidence which supported his allegation that he met the definition of disability Unum set forth its it disability insurance benefits policy.
Unum approved Michael’s long-term disability benefits and paid him disability insurance benefits for over eleven years.
In November 2014, Unum terminated Michael’s benefits and disability claims without any medical documentation supporting its allegation that Michael’s medical conditions had improved in such a way that it would have allowed him to return to any type of gainful occupation.
Long-Term Disability Benefits Wrongfully Terminated
According to the Unum lawsuit, Michael alleges that Unum obtained medical records which consisted of of “paper reviews” of his disability claims from two physicians.
Michael claims these doctors are employees of Unum and therefore have an incentive to “selectively review or ignore evidence such as occurred in [Michael’s] claim, in order to provide opinions and report(s)
Michael questions the impartiality and credibility of Unum’s own employees to fairly review his disability claims and believes these physicians’ opinions are a conflict of interest.
In July 2015, Michael submitted a letter from his treating physician who stated that Michael’s medical conditions prevent him from working in any occupation indefinitely.
A few months later, Unum informed Michael that its was upholding the decision to deny his long-term disability benefits.
Michael appealed this decision and provided even more documentation of his medical condition, but in April 2016, Unum notified Michael that his disability claims were denied and that he had exhausted all administrative levels of review.
Unum’s Bad Faith Insurance Tactics
Unum and its subsidiaries have repeatedly been found liable for questionable practices relating to denial of valid disability claims.
Among tactics allegedly used by insurers to unreasonably delay or deny disability claims is ignoring professional medical diagnosis or using biased experts, changing policies after a claim is filed, and claiming a person is not disabled and can work, despite a medical diagnosis from a professional.
Such tactics fall under bad faith insurance, and if an insurer has committed bad faith insurance, policyholders whose claims have been improperly or unreasonably denied or delayed may be eligible to file a complaint against the insurance company.
Michael is seeking reinstatement of his long-term disability benefits from the date he was first denied through present, an order directing Unum to continue paying his long-term disability benefits until he meets the conditions for termination of benefits, as well as court costs.
The Unum Long-Term Disability Benefits Lawsuit is Case. No. 2:16-cv-01560 in the U.S. District Court for the District of Arizona.
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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