Aurelio Gooden is like many Americans, assuming that his long-term disability (LTD) and life insurance company would step up to the plate if and when necessary. However, Gooden recently filed a disability insurance lawsuit when he discovered it was likely the only path to getting the compensation he claims he deserves.
Many Americans have Unum as their disability insurance provider, as it’s a very popular choice for their employers. However, the company has been under fire for its policies, even being exposed on major media outlets like CBS. Unum employees have verified and provided evidence that there were official “bonus systems” built into the company where Unum employees were financially rewarded for stopping payments or canceling the policies of the biggest claims.
Gooden found out about the Unum’s policies the hard way, after becoming eligible for LTD coverage. According many frustrated policyholders, Unum preys on people when they’re facing the most difficult of times. It’s not simple to qualify for disability benefits via the Social Security Administration (SSA), but that’s a requirement of Unum and many other LTD providers in order to receive LTD benefits from their policies.
Although Gooden qualified via the SSA, his compensation was denied by Unum. “By letter dated Jan. 8, 2013, (Unum) excluded (Gooden) from long-term disability insurance coverage on the ground that ‘his knee conditions are pre-existing.’ In fact, as attested by (Gooden’s) treating physician, within the relevant six-month period before his knee replacement surgery, (Gooden) was not treated for his left knee,” notes the Unum lawsuit.
“Indeed, in January 2012 and between Aug. 1, 2011 and Jan. 31, 2012, his physician did not see the need to treat, consult concerning, care for or service (Gooden’s) left knee,” continues Gooden’s Unum lawsuit.
“Notwithstanding these facts, the sole basis of disqualification assured by (Unum) is as follows: ‘As stated in our December 11, 2012 letter, the discussion about chronic pain in your left knee on January 4, 2012 is medication treatment, consultation, care of services under the terms of the policy. While the course of your treatment did not change, you underwent consultation or care for both knees during the six month timeframe of August 1, 2011 through January 31, 2012.’ Said basis is contrary to (Gooden’s) medical records and facts.”
A Last Resort
Dealing with a company which can’t (or chooses not to) differentiate between right and left can be maddening. A Unum lawsuit is the last resort for Gooden after exhausting every other possibility. Numerous appeals have reportedly done nothing to change Unum’s decision for a denial of benefits. “The denial of which (Gooden) contends was appealed and affirmed on appeal by (Gooden). On June 12, 2012, (Gooden) underwent total left knee replacement.” The recovery period involved no compensation from the policy he’d paid in to.
The Unum lawsuit is Aurelio A. Gooden v. First Unum Life Insurance Company, Case No. 7:13-cv-04210-KMK, in the U.S. District Court for the Southern District of New York.
Do You Have an Unlawful Unum Denial?
If you believe Unum wrongfully denied your claim or stopped payments, you may have an Unum legal claim. Find out what you can do next by visiting the Unum/UnumProvident Disability Insurance Claim Denial Class Action Lawsuit Investigation right now. Share your story, and an attorney will contact you if you have a case for a free Unum claim review.
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